DOUGLAS BROCK NELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

DOUGLAS BROCK

Last Name

NELSON

Suffix

Business Name

DOUGLAS BROCK NELSON MD

Original Issue Date

01/07/1982

Effective Date

01/07/1982

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011