ANJALI PALVIA SHAH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932754

License Status

NOT RENEWED

Business

First Name

ANJALI

Middle

PALVIA

Last Name

SHAH

Suffix

Business Name

ANJALI PALVIA SHAH OD

Original Issue Date

01/02/2007

Effective Date

01/02/2007

Expiration Date

03/31/2008

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008