KENT W PETERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112527

License Status

ACTIVE

Business

First Name

KENT

Middle

Last Name

PETERSON

Suffix

Business Name

KENT W PETERSON MD

Original Issue Date

10/15/2004

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

CHARLOTTESVILLE

State

Zip

22903

County

VIRGINIA

Ever Disciplined

LastModifiedDate

06/06/2023