PAMELA CAROL PETERSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061214

License Status

EXPIRED

Business

Title

First Name

PAMELA

Middle

CAROL

Last Name

PETERSEN

Business Name

PAMELA CAROL PETERSEN MD

Original Issue Date

06/28/2012

Effective Date

06/28/2012

Expiration Date

06/27/2015

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/04/2015