ANJALI PALVIA SHAH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****02

License Status

NOT RENEWED

Business

First Name

ANJALI

Middle

PALVIA

Last Name

SHAH

Suffix

Business Name

ANJALI PALVIA SHAH OD

Original Issue Date

02/02/2007

Effective Date

02/02/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008