SHAIROZ A FAZAL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926668

License Status

NOT RENEWED

Business

First Name

SHAIROZ

Middle

Last Name

FAZAL

Suffix

Business Name

SHAIROZ A FAZAL OD

Original Issue Date

12/23/1999

Effective Date

08/26/2003

Expiration Date

03/31/2000

City

OAKBROOK

State

Zip

60523

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/11/2005