NATHAN PAUL FREDRICK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122018

License Status

ACTIVE

Business

Title

First Name

NATHAN

Middle

PAUL

Last Name

FREDRICK

Business Name

NATHAN PAUL FREDRICK DO

Original Issue Date

10/01/2008

Effective Date

08/24/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Ever Disciplined

LastModifiedDate

08/24/2023