BRUCE L PETERSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

BRUCE L

Last Name

PETERSON

Business Name

BRUCE L PETERSON

Original Issue Date

04/07/1987

Effective Date

04/07/1987

Expiration Date

09/30/1996

City

HINSDALE

State

Zip

60521

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005