JOHN BERTHOLD NANNINGA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036039408

License Status

INACTIVE

Business

First Name

JOHN BERTHOLD

Last Name

NANNINGA

Suffix

Business Name

JOHN BERTHOLD NANNINGA MD

Original Issue Date

11/25/1964

Effective Date

05/05/2011

Expiration Date

07/31/2014

City

WINNETKA

State

Zip

60093

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014