KIMBERLY L GUNDERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****65

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

GUNDERSON

Suffix

Business Name

KIMBERLY L GUNDERSON OD

Original Issue Date

12/22/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008