TEJAL PATEL OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931640

License Status

CANCELLED

Business

Title

First Name

TEJAL

Last Name

PATEL

Business Name

TEJAL PATEL OD

Original Issue Date

12/07/2005

Effective Date

07/23/2008

Expiration Date

03/31/2010

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/04/2010