GREGG C PETERSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

First Name

GREGG C

Last Name

PETERSON

Business Name

GREGG C PETERSON

Original Issue Date

01/28/1985

Effective Date

01/28/1985

Expiration Date

09/30/2000

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005