License holder summary

Dr. WALTER R PETERSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for Dr. WALTER R PETERSEN is 631 SUMMERWOOD DR REXBURG ID 83440. This licensed professional license is not current. The license was granted 01/10/1966 and expired on 08/01/2014.

Idaho

Division of Occupational and Professional Licenses

Dr. WALTER R PETERSEN
Board Of Medicine
License number
M-2705
Date granted
01/10/1966
Date expires
08/01/2014
Class
Board Of Medicine
Status
Canceled
Address
631 SUMMERWOOD DR REXBURG ID 83440
idaholicensing.com
ID 48348794
LAST UPDATED 2024-04-01 12:50:21 UTC

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