NATHANIEL JOSEPH PETERSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019036159

License Status

ACTIVE

Business

Title

DMD

First Name

NATHANIEL

Middle

JOSEPH

Last Name

PETERSON

Business Name

NATHANIEL JOSEPH PETERSON DMD

Original Issue Date

06/15/2025

Effective Date

06/15/2025

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/15/2025