ROGER G NISSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

First Name

ROGER G

Last Name

NISSEN

Suffix

Business Name

ROGER G NISSEN MD

Original Issue Date

01/01/1997

Effective Date

05/12/2023

Expiration Date

07/31/2026

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/12/2023