SHAWN P MALLADY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925353

License Status

NOT RENEWED

Business

First Name

SHAWN P

Last Name

MALLADY

Suffix

Business Name

SHAWN P MALLADY OD

Original Issue Date

06/03/1997

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/11/2005