DAVID R PETERSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

DAVID

Middle

Last Name

PETERSON

Business Name

DAVID R PETERSON

Original Issue Date

08/14/2002

Effective Date

06/24/2023

Expiration Date

07/31/2026

City

STAUNTION

State

Zip

62088

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/24/2023