NATHAN JOSEPH STACKHOUSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140205

License Status

ACTIVE

Business

First Name

NATHAN

Middle

JOSEPH

Last Name

STACKHOUSE

Suffix

Business Name

NATHAN JOSEPH STACKHOUSE MD

Original Issue Date

03/30/2016

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

07/04/2023