License holder summary

Peterson, Alan - Indiana/Ohio Heart is a Medical Board - 41.Pa Supervision Agreement licensed to practice in Ohio. The address on file for Peterson, Alan - Indiana/Ohio Heart is 7910 W. Jefferson Blvd, Suite 102, Ft. Wayne,, IN 46804. This licensed professional license is current. The license was granted 09/09/2004 and expired on 01/31/2015.

Ohio

Board of Licensing

Peterson, Alan - Indiana/Ohio Heart
Medical Board - 41.Pa Supervision Agreement
License number
41.867-SA
Date granted
09/09/2004
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
7910 W. Jefferson Blvd, Suite 102, Ft. Wayne,, IN 46804
ohiolicensing.org
ID 28674521
LAST UPDATED 2024-01-31 07:24:26 UTC

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