SHAWN P MALLADY OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930010

License Status

CANCELLED

Business

First Name

SHAWN P

Last Name

MALLADY

Suffix

Business Name

SHAWN P MALLADY OD

Original Issue Date

03/03/2004

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/04/2010