RENUKA SIVANESAN Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935697

License Status

CANCELLED

Business

First Name

RENUKA

Last Name

SIVANESAN

Business Name

RENUKA SIVANESAN

Original Issue Date

09/17/2009

Effective Date

09/17/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010