NATHAN THOMAS VAN DYK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

THOMAS

Last Name

VAN DYK

Suffix

Business Name

NATHAN THOMAS VAN DYK MD

Original Issue Date

11/12/2008

Effective Date

11/12/2008

Expiration Date

07/31/2011

City

WAUKEGAN

State

Zip

60085

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011