TIMOTHY JAMES PETERSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072502

License Status

CANCELLED

Business

Title

First Name

TIMOTHY

Middle

JAMES

Last Name

PETERSON

Business Name

TIMOTHY JAMES PETERSON MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/22/2018