JAMES EDWARD PETERSEN - Dentist License in Illinois | # 019010778

JAMES EDWARD PETERSEN

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010778

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005