TODD J PETERSEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002723

License Status

ACTIVE

Business

First Name

TODD

Middle

Last Name

PETERSEN

Business Name

TODD J PETERSEN

Original Issue Date

06/15/2006

Effective Date

01/06/2026

Expiration Date

03/01/2028

City

ALTON

State

Zip

62002

Ever Disciplined

LastModifiedDate

01/06/2026