RUSSELL N PETERSEN DC Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038010257

License Status

INACTIVE

Business

First Name

RUSSELL

Middle

Last Name

PETERSEN

Suffix

Business Name

RUSSELL N PETERSEN DC

Original Issue Date

09/20/2004

Effective Date

09/20/2004

Expiration Date

07/31/2005

City

MARBLEHEAD

State

Zip

43440

County

OHIO

Ever Disciplined

LastModifiedDate

10/09/2006