LANCE R PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

LANCE R

Last Name

PETERSON

Suffix

Business Name

LANCE R PETERSON MD

Original Issue Date

12/26/1991

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021