PRAYAG D SHAH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929653

License Status

NOT RENEWED

Business

First Name

PRAYAG

Middle

Last Name

SHAH

Suffix

Business Name

PRAYAG D SHAH OD

Original Issue Date

08/25/2003

Effective Date

02/06/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006