DAVID R PETERSON DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018002064

License Status

CANCELLED

Business

First Name

DAVID R

Last Name

PETERSON

Suffix

DDS

Business Name

DAVID R PETERSON DDS

Original Issue Date

05/24/2018

Effective Date

05/24/2018

Expiration Date

05/24/2021

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

05/24/2018