WAYNE W PETERSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014605

License Status

EXPIRED

Business

First Name

WAYNE

Middle

Last Name

PETERSON

Suffix

Business Name

WAYNE W PETERSON MD

Original Issue Date

06/30/1982

Effective Date

06/30/1982

Expiration Date

06/28/1984

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006