BRIAN G PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111637

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

PETERSON

Suffix

Business Name

BRIAN G PETERSON MD

Original Issue Date

06/18/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

02/10/2010