NATHANIEL J SOPER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

NATHANIEL

Middle

Last Name

SOPER

Suffix

Business Name

NATHANIEL J SOPER MD

Original Issue Date

11/14/2003

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021