MADISON NICOLE PETERSEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

ACTIVE

Business

First Name

MADISON

Middle

NICOLE

Last Name

PETERSEN

Business Name

MADISON NICOLE PETERSEN

Original Issue Date

01/07/2025

Effective Date

02/19/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/19/2026