MINNA BLOCH PETERSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

CANCELLED

Business

First Name

MINNA BLOCH

Last Name

PETERSEN

Suffix

Business Name

MINNA BLOCH PETERSEN MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006