NATANIEL T VASQUEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

NATANIEL

Middle

Last Name

VASQUEZ

Business Name

NATANIEL T VASQUEZ

Original Issue Date

04/18/2011

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014