PETER HARRIS SEIDENBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

PETER

Middle

HARRIS

Last Name

SEIDENBERG

Suffix

Business Name

PETER HARRIS SEIDENBERG MD

Original Issue Date

10/21/2003

Effective Date

10/21/2003

Expiration Date

07/31/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008