FREDERICK D PETERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036116870

License Status

NOT RENEWED

Business

First Name

FREDERICK

Middle

Last Name

PETERSON

Suffix

Business Name

FREDERICK D PETERSON MD

Original Issue Date

09/05/2006

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SAINT LOUIS

State

Zip

63101

Ever Disciplined

LastModifiedDate

11/14/2011

Case Number

2010007719

Action

Refuse To Renew

Discipline Start Date

05/24/2011

Discipline Reason

after being disciplined by the state of Missouri for failure to file state income tax returns.