ALLEN NATHANIEL GUSTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

Title

First Name

ALLEN

Middle

NATHANIEL

Last Name

GUSTIN

Business Name

ALLEN NATHANIEL GUSTIN MD

Original Issue Date

03/18/2010

Effective Date

03/18/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020