CHAD WILLIAM PETERSEN DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001887

License Status

EXPIRED

Business

Title

DDS

First Name

CHAD

Middle

WILLIAM

Last Name

PETERSEN

Business Name

CHAD WILLIAM PETERSEN DDS

Original Issue Date

07/10/2013

Effective Date

07/10/2013

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/19/2017