JERALD MILES PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036136177

License Status

NOT RENEWED

Business

Title

First Name

JERALD

Middle

MILES

Last Name

PETERSON

Business Name

JERALD MILES PETERSON MD

Original Issue Date

08/07/2014

Effective Date

08/07/2014

Expiration Date

07/31/2017

City

MINNEAPOLIS

State

Zip

55403

County

MINNESOTA

Ever Disciplined

LastModifiedDate

11/01/2017