NATHAN HOLT FEDORS 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

Title

First Name

NATHAN

Middle

HOLT

Last Name

FEDORS

Business Name

NATHAN HOLT FEDORS MD

Original Issue Date

08/18/2011

Effective Date

08/18/2011

Expiration Date

07/31/2014

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014