TRACEY LYNN PETHOUD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009160

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

LYNN

Last Name

PETHOUD

Suffix

Business Name

TRACEY LYNN PETHOUD OD

Original Issue Date

06/01/1999

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

ST LOUIS

State

Zip

63139

County

MISSOURI

Ever Disciplined

LastModifiedDate

05/04/2010