AMBER M PETERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

AMBER

Middle

Last Name

PETERSON

Business Name

AMBER M PETERSON

Original Issue Date

06/02/2008

Effective Date

04/23/2014

Expiration Date

07/31/2017

City

CAMBRIDGE

State

Zip

61238

County

HENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017