JOHAN FREDRIK NORDENSTAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

Title

First Name

JOHAN

Middle

FREDRIK

Last Name

NORDENSTAM

Business Name

JOHAN FREDRIK NORDENSTAM MD

Original Issue Date

08/22/2013

Effective Date

07/27/2020

Expiration Date

07/31/2023

City

RIVERSIDE

State

Zip

60546

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023