BRIAN G PETERSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040862

License Status

EXPIRED

Business

First Name

BRIAN

Middle

Last Name

PETERSON

Suffix

Business Name

BRIAN G PETERSON MD

Original Issue Date

06/20/2000

Effective Date

06/20/2000

Expiration Date

06/19/2005

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006