DAVID NATHAN MAIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

NATHAN

Last Name

MAIN

Business Name

DAVID NATHAN MAIN MD

Original Issue Date

12/07/2016

Effective Date

12/07/2016

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017