RANDALL BENJAMIN PETERS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

Title

First Name

RANDALL

Middle

BENJAMIN

Last Name

PETERS

Business Name

RANDALL BENJAMIN PETERS MD

Original Issue Date

04/30/2013

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

CARTHAGE

State

Zip

62321

County

HANCOCK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

01/14/2021