NATHAN JEREMY SUSNOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126222

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

JEREMY

Last Name

SUSNOW

Suffix

Business Name

NATHAN JEREMY SUSNOW MD

Original Issue Date

07/08/2010

Effective Date

07/08/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011