ROBERT KENNETH PETERSON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

First Name

ROBERT KENNETH

Last Name

PETERSON

Suffix

DMD

Business Name

ROBERT KENNETH PETERSON DMD

Original Issue Date

04/22/1987

Effective Date

04/22/1987

Expiration Date

09/30/1996

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005