NATHAN JOSEPH STACKHOUSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

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

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023