PATRICIA A NICKELSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000265

License Status

NOT RENEWED

Business

First Name

PATRICIA

Middle

Last Name

NICKELSON

Business Name

PATRICIA A NICKELSON

Original Issue Date

07/01/1988

Effective Date

07/01/1988

Expiration Date

06/30/1992

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/12/2005