NATHAN DOUGLAS BURSTEDT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078064

License Status

EXPIRED

Business

Title

First Name

NATHAN

Middle

DOUGLAS

Last Name

BURSTEDT

Business Name

NATHAN DOUGLAS BURSTEDT MD

Original Issue Date

06/22/2021

Effective Date

06/22/2021

Expiration Date

06/21/2022

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/11/2022