DANIEL SCOTT PETERSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073406

License Status

EXPIRED

Business

Title

First Name

DANIEL

Middle

SCOTT

Last Name

PETERSEN

Business Name

DANIEL SCOTT PETERSEN MD

Original Issue Date

07/11/2018

Effective Date

07/11/2018

Expiration Date

07/10/2021

City

CHICAGO

State

Zip

60608

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022