JAMES EDWARD PETERSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010778

License Status

NOT RENEWED

Business

First Name

JAMES EDWARD

Last Name

PETERSEN

Business Name

JAMES EDWARD PETERSEN

Original Issue Date

08/25/1955

Effective Date

08/25/1955

Expiration Date

09/30/2004

City

OREGON

State

Zip

61061

County

OGLE

Ever Disciplined

LastModifiedDate

10/17/2005