DAVID R PETERSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107652

License Status

ACTIVE

Business

First Name

DAVID

Middle

Last Name

PETERSON

Business Name

DAVID R PETERSON

Original Issue Date

08/08/2002

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/14/2023