LELAND DAVID PETERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****39

License Status

NOT RENEWED

Business

First Name

LELAND

Middle

DAVID

Last Name

PETERSON

Suffix

Business Name

LELAND DAVID PETERSON OD

Original Issue Date

12/01/2003

Effective Date

03/25/2014

Expiration Date

03/31/2016

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016