ROGER DWIGHT PETERSEN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040486

License Status

INACTIVE

Business

First Name

ROGER DWIGHT

Last Name

PETERSEN

Suffix

Business Name

ROGER DWIGHT PETERSEN MD

Original Issue Date

07/05/1966

Effective Date

07/05/1966

Expiration Date

07/31/1987

City

BOCA RATON

State

Zip

33432

County

FLORIDA

Ever Disciplined

LastModifiedDate

09/20/2006