ANDREW DODD PETERSEN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

DODD

Last Name

PETERSEN

Business Name

ANDREW DODD PETERSEN DO

Original Issue Date

05/07/2024

Effective Date

05/07/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2024