DAVID R PETERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

DAVID R

Last Name

PETERSON

Suffix

DDS

Business Name

DAVID R PETERSON DDS

Original Issue Date

02/06/2023

Effective Date

02/06/2023

Expiration Date

09/30/2024

City

YORKVILLE

State

Zip

60560

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025