GUY A PETERSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

GUY A

Last Name

PETERSEN

Suffix

Business Name

GUY A PETERSEN MD

Original Issue Date

07/23/1986

Effective Date

07/23/1986

Expiration Date

07/31/1996

City

ELMHURST

State

Zip

60126

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006