GEORGE RONEN NISSAN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108447

License Status

ACTIVE

Business

First Name

GEORGE

Middle

RONEN

Last Name

NISSAN

Suffix

Business Name

GEORGE RONEN NISSAN DO

Original Issue Date

01/16/2003

Effective Date

10/16/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60642

Ever Disciplined

LastModifiedDate

10/16/2023