BRENT MICHAEL NATHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067282

License Status

CANCELLED

Business

Title

First Name

BRENT

Middle

MICHAEL

Last Name

NATHAN

Business Name

BRENT MICHAEL NATHAN MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/03/2015