DIANE Y PETERSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014536

License Status

EXPIRED

Business

First Name

DIANE Y

Last Name

PETERSEN

Suffix

Business Name

DIANE Y PETERSEN MD

Original Issue Date

06/30/1982

Effective Date

06/30/1982

Expiration Date

07/01/1984

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006