DOUGLAS O NICHOLS DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

CANCELLED

Business

First Name

DOUGLAS O

Last Name

NICHOLS

Suffix

DDS

Business Name

DOUGLAS O NICHOLS DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

DECATUR

State

Zip

62525

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006