MARK E PETERSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111051

License Status

ACTIVE

Business

First Name

MARK

Middle

Last Name

PETERSON

Business Name

MARK E PETERSON

Original Issue Date

03/19/2004

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

04/06/2023