JERALD MILES PETERSON MD - Medical Doctor License in Minnesota | # 33*****97

JERALD MILES PETERSON MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

N

Title

MD

First Name

JERALD

Middle

MILES

Last Name

PETERSON

Business Name

JERALD MILES PETERSON MD

Original Issue Date

08/07/2014

Effective Date

08/07/2014

Expiration Date

07/31/2017

State

MN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

11/01/2017