PETER MARTIN VANDENBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

PETER MARTIN

Last Name

VANDENBERG

Suffix

Business Name

PETER MARTIN VANDENBERG MD

Original Issue Date

01/05/1987

Effective Date

01/05/1987

Expiration Date

07/31/1990

City

JOLIET

State

Zip

60435

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006