TATYANA VLADIMIROVNA PETROSOVA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

TATYANA

Middle

VLADIMIROVNA

Last Name

PETROSOVA

Suffix

Business Name

TATYANA VLADIMIROVNA PETROSOVA MD

Original Issue Date

08/26/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011