JAMES STEPHEN PETERSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

ACTIVE

Business

Title

DDS

First Name

JAMES

Middle

STEPHEN

Last Name

PETERSON

Business Name

JAMES STEPHEN PETERSON DDS

Original Issue Date

06/08/2012

Effective Date

05/15/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/15/2024