CAROLINE PETERSON Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****61

License Status

INOPERATIVE

Business

First Name

CAROLINE

Last Name

PETERSON

Business Name

CAROLINE PETERSON

Original Issue Date

03/22/2001

Effective Date

02/27/2012

Expiration Date

03/01/2014

City

GURNEE

State

Zip

60031

County

LAKE

Ever Disciplined

LastModifiedDate

04/12/2012