LARRY DEAN PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

LARRY DEAN

Last Name

PETERSON

Suffix

Business Name

LARRY DEAN PETERSON MD

Original Issue Date

01/01/1997

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021