PETER J ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

PETER J

Last Name

ANDERSON

Suffix

Business Name

PETER J ANDERSON MD

Original Issue Date

03/07/1990

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021