GERALD ROGER PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037854

License Status

NOT RENEWED

Business

First Name

GERALD ROGER

Last Name

PETERSON

Suffix

Business Name

GERALD ROGER PETERSON MD

Original Issue Date

07/13/1962

Effective Date

06/03/2011

Expiration Date

07/31/2014

City

BELVIDERE

State

Zip

61008

County

BOONE

Ever Disciplined

LastModifiedDate

11/17/2014