NATHAN THOMAS VAN DYK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122028

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

THOMAS

Last Name

VAN DYK

Suffix

Business Name

NATHAN THOMAS VAN DYK MD

Original Issue Date

10/02/2008

Effective Date

07/18/2011

Expiration Date

07/31/2014

City

FAIRFIELD

State

Zip

94533

Ever Disciplined

LastModifiedDate

11/17/2014