QUINN PHILLIPS GALLEN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****54

License Status

NOT RENEWED

Business

First Name

QUINN

Middle

PHILLIPS

Last Name

GALLEN

Business Name

QUINN PHILLIPS GALLEN

Original Issue Date

06/17/2020

Effective Date

06/17/2020

Expiration Date

05/31/2022

City

CHESTERFIELD

State

Zip

63017

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

07/27/2022