PEER O THEOBALD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107874

License Status

NOT RENEWED

Business

First Name

PEER

Middle

Last Name

THEOBALD

Suffix

Business Name

PEER O THEOBALD MD

Original Issue Date

09/18/2002

Effective Date

06/14/2011

Expiration Date

07/31/2014

City

FAIRBANKS

State

Zip

99709

County

ALASKA

Ever Disciplined

LastModifiedDate

11/17/2014