NATHANIEL T DIAZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038112

License Status

EXPIRED

Business

First Name

NATHANIEL

Middle

Last Name

DIAZ

Business Name

NATHANIEL T DIAZ

Original Issue Date

06/16/1998

Effective Date

06/16/1998

Expiration Date

06/15/2002

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006