CHAITALI SHUKLA OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935143

License Status

CANCELLED

Business

First Name

CHAITALI

Last Name

SHUKLA

Suffix

Business Name

CHAITALI SHUKLA OD

Original Issue Date

03/09/2009

Effective Date

03/09/2009

Expiration Date

03/31/2010

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

05/04/2010