BRENT P PETERSON DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092091

License Status

INACTIVE

Business

First Name

BRENT P

Last Name

PETERSON

Suffix

Business Name

BRENT P PETERSON DO

Original Issue Date

10/18/1995

Effective Date

10/18/1995

Expiration Date

07/31/1996

City

GARDEN CITY

State

Zip

48135

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/06/2017