LACIE RENEE PETRO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119502

License Status

ACTIVE

Business

First Name

LACIE

Middle

RENEE

Last Name

PETRO

Suffix

Business Name

LACIE RENEE PETRO MD

Original Issue Date

10/09/2007

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/18/2023