DAVID E NISSAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062588

License Status

NOT RENEWED

Business

First Name

DAVID E

Last Name

NISSAN

Suffix

Business Name

DAVID E NISSAN MD

Original Issue Date

07/27/1981

Effective Date

06/30/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023