NATHANAEL JAMES DOLAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

NATHANAEL

Middle

JAMES

Last Name

DOLAN

Suffix

Business Name

NATHANAEL JAMES DOLAN MD

Original Issue Date

06/09/2009

Effective Date

06/14/2011

Expiration Date

07/31/2014

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020