SHANTA NATH 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

SHANTA

Last Name

NATH

Suffix

Business Name

SHANTA NATH MD

Original Issue Date

05/03/1985

Effective Date

05/12/2014

Expiration Date

07/31/2017

City

DARIEN

State

Zip

60561

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017