PRAYAG D SHAH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929325

License Status

NOT RENEWED

Business

First Name

PRAYAG

Middle

Last Name

SHAH

Suffix

Business Name

PRAYAG D SHAH OD

Original Issue Date

02/20/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

PRINCETON

State

Zip

61356

County

BUREAU

Ever Disciplined

LastModifiedDate

09/11/2005