LARRY WILLIAM PETERSON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011988

License Status

INACTIVE

Business

First Name

LARRY WILLIAM

Last Name

PETERSON

Suffix

DDS

Business Name

LARRY WILLIAM PETERSON DDS

Original Issue Date

08/16/1961

Effective Date

08/16/1961

Expiration Date

09/30/2004

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005