License holder summary

PHILLIP H PETERSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for PHILLIP H PETERSEN is 301 Cedar Orofino ID 83544. This licensed professional license is current. The license was granted 09/06/1988 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

PHILLIP H PETERSEN
Board Of Medicine
License number
M-5405
Date granted
09/06/1988
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
301 Cedar Orofino ID 83544
idaholicensing.com
ID 48348789
LAST UPDATED 2024-04-04 00:49:07 UTC

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