STANTON JOHN NIELSEN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

STANTON

Middle

JOHN

Last Name

NIELSEN

Business Name

STANTON JOHN NIELSEN DO

Original Issue Date

06/07/2023

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023