KRISTA KAYE THOMASSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****12

License Status

NOT RENEWED

Business

First Name

KRISTA

Middle

KAYE

Last Name

THOMASSON

Suffix

Business Name

KRISTA KAYE THOMASSON OD

Original Issue Date

01/29/2003

Effective Date

03/01/2004

Expiration Date

03/31/2006

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/11/2006