TIMOTHY WARREN PETERSON - Physician Assistant License in Illinois | # 085003932

TIMOTHY WARREN PETERSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003932

License Status

NOT RENEWED

Business

N

First Name

TIMOTHY

Middle

WARREN

Last Name

PETERSON

Business Name

TIMOTHY WARREN PETERSON

Original Issue Date

10/07/2010

Effective Date

02/16/2012

Expiration Date

03/01/2014

State

IL

Ever Disciplined

N

LastModifiedDate

04/08/2014