REBECCA Y PETERSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

Title

First Name

REBECCA

Middle

Last Name

PETERSEN

Business Name

REBECCA Y PETERSEN MD

Original Issue Date

06/02/2021

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023