ROBERT LYNN PETERSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

Title

First Name

ROBERT

Middle

LYNN

Last Name

PETERSEN

Business Name

ROBERT LYNN PETERSEN MD

Original Issue Date

05/21/2021

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

EDWARDSVILLE

State

Zip

62025

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023