BRUCE PATTEN PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

BRUCE PATTEN

Last Name

PETERSON

Suffix

Business Name

BRUCE PATTEN PETERSON MD

Original Issue Date

07/29/1981

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020