License holder summary

MICHAEL THEODORE PETERSON is a Medical Residency Permit licensed to practice in Indiana. The address on file for MICHAEL THEODORE PETERSON is SOUTH BEND IN 46615. This licensed professional license is not current. The license was granted 07/01/1989 and expired on 06/30/1990.

Indiana

Professional Licensing Agency

MICHAEL THEODORE PETERSON
Medical Residency Permit
License number
11005054A
Date granted
07/01/1989
Date expires
06/30/1990
Class
Medical Residency Permit
Status
Expired
Address
SOUTH BEND IN 46615
indianalicensing.org
ID 5996606
LAST UPDATED 2024-02-13 05:34:03 UTC

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