SHELLEY MINGWEN WU OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****33

License Status

NOT RENEWED

Business

First Name

SHELLEY

Middle

MINGWEN

Last Name

Suffix

Business Name

SHELLEY MINGWEN WU OD

Original Issue Date

07/19/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005