JILLIAN ELAINE PETERSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062229

License Status

EXPIRED

Business

First Name

JILLIAN

Middle

ELAINE

Last Name

PETERSON

Suffix

Business Name

JILLIAN ELAINE PETERSON MD

Original Issue Date

06/27/2012

Effective Date

06/27/2012

Expiration Date

06/26/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/04/2015