LARRY WILLIAM PETERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

LARRY WILLIAM

Last Name

PETERSON

Suffix

DDS

Business Name

LARRY WILLIAM PETERSON DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005