JULIAN S CHESTNUT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

JULIAN S

Last Name

CHESTNUT

Business Name

JULIAN S CHESTNUT

Original Issue Date

05/01/1984

Effective Date

07/08/2020

Expiration Date

07/31/2023

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023