AMBER M PETERSON Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047797

License Status

CANCELLED

Business

First Name

AMBER

Middle

Last Name

PETERSON

Business Name

AMBER M PETERSON

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006