BRIAN RAY PETERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

Title

First Name

BRIAN

Middle

RAY

Last Name

PETERSON

Business Name

BRIAN RAY PETERSON MD

Original Issue Date

02/17/2017

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2023