MARSHALL EDGAR PEDERSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

MARSHALL EDGAR

Last Name

PEDERSEN

Suffix

Business Name

MARSHALL EDGAR PEDERSEN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CRYSTAL LAKE

State

Zip

60012

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020