MARY B NORDSTROM 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

MARY B

Last Name

NORDSTROM

Suffix

Business Name

MARY B NORDSTROM MD

Original Issue Date

07/30/1991

Effective Date

07/30/1991

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006