NATHAN JEREMY SUSNOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

JEREMY

Last Name

SUSNOW

Suffix

Business Name

NATHAN JEREMY SUSNOW MD

Original Issue Date

08/02/2010

Effective Date

08/02/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011