KEVIN C PETERSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

PETERSEN

Suffix

Business Name

KEVIN C PETERSEN MD

Original Issue Date

12/26/1986

Effective Date

12/26/1986

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60660

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006