ROBERT DOUGLAS PETRIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

ROBERT DOUGLAS

Last Name

PETRIE

Suffix

Business Name

ROBERT DOUGLAS PETRIE MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006