DAVID R PETERSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

ACTIVE

Business

First Name

DAVID R

Last Name

PETERSON

Suffix

DDS

Business Name

DAVID R PETERSON DDS

Original Issue Date

03/12/2021

Effective Date

09/16/2024

Expiration Date

09/30/2027

City

GLEN ELLYN

State

Zip

60137

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/16/2024