FREDERICK D PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

FREDERICK

Middle

Last Name

PETERSON

Suffix

Business Name

FREDERICK D PETERSON MD

Original Issue Date

11/08/2006

Effective Date

11/08/2006

Expiration Date

07/31/2008

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011