MARK L PETERSEN MD - Medical Doctor License in Idaho | # 036066326

MARK L PETERSEN MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066326

License Status

INACTIVE

Business

N

First Name

MARK L

Last Name

PETERSEN

Suffix

MD

Business Name

MARK L PETERSEN MD

Original Issue Date

03/25/1983

Effective Date

03/25/1983

Expiration Date

07/31/1987

State

ID

Ever Disciplined

N

LastModifiedDate

09/20/2006