BRENT H PETERSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

First Name

BRENT H

Last Name

PETERSEN

Suffix

Business Name

BRENT H PETERSEN MD

Original Issue Date

09/09/1987

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

CARY

State

Zip

60013

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023