SHAIROZ A FAZAL OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934816

License Status

CANCELLED

Business

First Name

SHAIROZ

Middle

Last Name

FAZAL

Suffix

Business Name

SHAIROZ A FAZAL OD

Original Issue Date

11/03/2008

Effective Date

11/03/2008

Expiration Date

03/31/2010

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/04/2010