TODD CORY GUNDERSON 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

TODD

Middle

CORY

Last Name

GUNDERSON

Suffix

Business Name

TODD CORY GUNDERSON OD

Original Issue Date

10/04/2001

Effective Date

02/24/2004

Expiration Date

03/31/2006

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006