SAMANTHA ELIZABETH PETERSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073422

License Status

CANCELLED

Business

Title

First Name

SAMANTHA

Middle

ELIZABETH

Last Name

PETERSON

Business Name

SAMANTHA ELIZABETH PETERSON DO

Original Issue Date

08/06/2018

Effective Date

08/06/2018

Expiration Date

08/05/2021

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Family Medicine and OMT

Ever Disciplined

LastModifiedDate

08/06/2018