ALLISON W PETERSEN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

INOPERATIVE

Business

First Name

ALLISON

Middle

Last Name

PETERSEN

Business Name

ALLISON W PETERSEN

Original Issue Date

02/03/2010

Effective Date

01/28/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/01/2014