PERRY A PETERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

PERRY A

Last Name

PETERSON

Business Name

PERRY A PETERSON

Original Issue Date

05/22/1995

Effective Date

05/22/1995

Expiration Date

07/31/1999

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006