JENNIFER PETERSEN-GOLDSPIEL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

CANCELLED

Business

First Name

JENNIFER

Last Name

PETERSEN-GOLDSPIEL

Business Name

JENNIFER PETERSEN-GOLDSPIEL

Original Issue Date

10/26/1999

Effective Date

10/26/1999

Expiration Date

07/31/2005

City

AURORA

State

Zip

60506

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006