PETER A TRACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048526

License Status

NOT RENEWED

Business

First Name

PETER A

Last Name

TRACE

Suffix

Business Name

PETER A TRACE MD

Original Issue Date

12/18/1973

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

ROODHOUSE

State

Zip

62082

County

MORGAN

Ever Disciplined

LastModifiedDate

01/14/2021