JARED STEVEN NIELSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

JARED

Middle

STEVEN

Last Name

NIELSEN

Suffix

Business Name

JARED STEVEN NIELSEN MD

Original Issue Date

03/02/2005

Effective Date

09/22/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017