KIMBERLY L GUNDERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****06

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

GUNDERSON

Suffix

Business Name

KIMBERLY L GUNDERSON OD

Original Issue Date

10/09/2001

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