NATHAN DOUGLAS GEORGE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070315

License Status

CANCELLED

Business

Title

First Name

NATHAN

Middle

DOUGLAS

Last Name

GEORGE

Business Name

NATHAN DOUGLAS GEORGE MD

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/15/2017