DUSTIN JAY PETERSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036167139

License Status

ACTIVE

Business

Title

First Name

DUSTIN

Middle

JAY

Last Name

PETERSEN

Business Name

DUSTIN JAY PETERSEN MD

Original Issue Date

09/22/2023

Effective Date

09/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

04/06/2023