JON FREDRICK PETERSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

Title

First Name

JON

Middle

FREDRICK

Last Name

PETERSEN

Business Name

JON FREDRICK PETERSEN MD

Original Issue Date

03/06/2012

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

BRANSON

State

Zip

65616

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021