ROBERT B NORDSTROM Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

ROBERT

Middle

Last Name

NORDSTROM

Business Name

ROBERT B NORDSTROM

Original Issue Date

06/18/2003

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023