JENNIFER LYNN SHANE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927530

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

LYNN

Last Name

SHANE

Suffix

Business Name

JENNIFER LYNN SHANE OD

Original Issue Date

10/24/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005