NATHANIEL T DIAZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

NATHANIEL

Middle

Last Name

DIAZ

Business Name

NATHANIEL T DIAZ

Original Issue Date

02/06/2003

Effective Date

02/06/2003

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008