SHANE RONALD BRAUN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926780

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

RONALD

Last Name

BRAUN

Suffix

Business Name

SHANE RONALD BRAUN OD

Original Issue Date

02/22/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005