NATHAN HOLT FEDORS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128494

License Status

NOT RENEWED

Business

Title

First Name

NATHAN

Middle

HOLT

Last Name

FEDORS

Business Name

NATHAN HOLT FEDORS MD

Original Issue Date

07/13/2011

Effective Date

07/13/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014