ANNETTE RAQUEL NATHAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

ANNETTE RAQUEL

Last Name

NATHAN

Suffix

Business Name

ANNETTE RAQUEL NATHAN MD

Original Issue Date

03/11/1997

Effective Date

03/11/1997

Expiration Date

07/31/1999

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006