MARY KATHRYN PETERSON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050981

License Status

EXPIRED

Business

First Name

MARY

Middle

KATHRYN

Last Name

PETERSON

Suffix

Business Name

MARY KATHRYN PETERSON DO

Original Issue Date

06/19/2006

Effective Date

06/19/2006

Expiration Date

06/18/2009

City

PARK RIDGE

State

Zip

60068

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/15/2009