DOUGLAS DIRK NELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068655

License Status

NOT RENEWED

Business

First Name

DOUGLAS DIRK

Last Name

NELSON

Suffix

Business Name

DOUGLAS DIRK NELSON MD

Original Issue Date

05/14/1984

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021