PETER REID KONGSTVEDT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

PETER REID

Last Name

KONGSTVEDT

Suffix

Business Name

PETER REID KONGSTVEDT MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1984

City

ANNA

State

Zip

62906

County

UNION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006