SELENA PETERSON 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

SELENA

Last Name

PETERSON

Suffix

Business Name

SELENA PETERSON MD

Original Issue Date

08/22/1991

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

RICHTON PARK

State

Zip

60471

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021