THOMAS WILLIAM PETTINGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112607

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

WILLIAM

Last Name

PETTINGER

Suffix

Business Name

THOMAS WILLIAM PETTINGER MD

Original Issue Date

11/05/2004

Effective Date

06/23/2011

Expiration Date

07/31/2014

City

EDEN PRAIRIE

State

Zip

55344

County

MINNESOTA

Ever Disciplined

LastModifiedDate

11/17/2014