MICHAEL J PETERSEN DPM - Podiatrist License in Illinois | # 016002938

MICHAEL J PETERSEN DPM

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002938

License Status

NOT RENEWED

Business

N

First Name

MICHAEL

Middle

J

Last Name

PETERSEN

Suffix

DPM

Business Name

MICHAEL J PETERSEN DPM

Original Issue Date

08/03/1977

Effective Date

12/09/2014

Expiration Date

01/31/2017

State

IL

Ever Disciplined

N

LastModifiedDate

03/27/2017