SAMANTHA ELIZABETH PETERSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

Title

First Name

SAMANTHA

Middle

ELIZABETH

Last Name

PETERSON

Business Name

SAMANTHA ELIZABETH PETERSON DO

Original Issue Date

03/12/2021

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

OLYMPIA FIELDS

State

Zip

60461

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023