License holder summary

SHANE LEWIS PETERSEN is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for SHANE LEWIS PETERSEN is NO CITY PA 00000. This medical practitioner license is not current. The license was granted 06/24/2001 and expired on 06/23/2002.

Department of State

Board of Medicine

SHANE LEWIS PETERSEN
Graduate Medical Trainee
License number
MT049513T
Date granted
06/24/2001
Date expires
06/23/2002
Class
Graduate Medical Trainee
Status
Inactive
Address
NO CITY PA 00000
medicinepa.com
ID 37558776
LAST UPDATED 2026-04-07 09:19:38 UTC

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