ROBERT DOUGLAS PETRIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054305

License Status

NOT RENEWED

Business

First Name

ROBERT DOUGLAS

Last Name

PETRIE

Suffix

Business Name

ROBERT DOUGLAS PETRIE MD

Original Issue Date

03/11/1977

Effective Date

03/11/1977

Expiration Date

07/01/1980

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/02/2014