KATLYN R PETERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****79

License Status

NOT RENEWED

Business

Title

First Name

KATLYN

Middle

Last Name

PETERSON

Business Name

KATLYN R PETERSON OD

Original Issue Date

12/04/2020

Effective Date

12/04/2020

Expiration Date

05/31/2022

City

ST LOUIS

State

Zip

63118

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022