PEGGY KOOP Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****79

License Status

INACTIVE

Business

First Name

PEGGY

Last Name

KOOP

Business Name

PEGGY KOOP

Original Issue Date

07/29/1997

Effective Date

04/01/2002

Expiration Date

03/31/2002

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005