MARK E PETERSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

First Name

MARK

Middle

Last Name

PETERSON

Business Name

MARK E PETERSON

Original Issue Date

04/13/2004

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

OSWEGO

State

Zip

60543

County

KENDALL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023