DUSTIN JAY PETERSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

Title

First Name

DUSTIN

Middle

JAY

Last Name

PETERSEN

Business Name

DUSTIN JAY PETERSEN MD

Original Issue Date

10/06/2023

Effective Date

10/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60617

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/06/2023