KIRK D KVITLE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****23

License Status

NOT RENEWED

Business

First Name

KIRK D

Last Name

KVITLE

Business Name

KIRK D KVITLE

Original Issue Date

05/16/1996

Effective Date

02/26/2020

Expiration Date

05/31/2022

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022