LACIE RENEE PETRO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

ACTIVE

Business

First Name

LACIE

Middle

RENEE

Last Name

PETRO

Suffix

Business Name

LACIE RENEE PETRO MD

Original Issue Date

12/20/2007

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023