DOUGLAS DIRK NELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

DOUGLAS DIRK

Last Name

NELSON

Suffix

Business Name

DOUGLAS DIRK NELSON MD

Original Issue Date

12/05/1984

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021