PAUL RUSSELL A NICOTRA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

PAUL

Middle

RUSSELL A

Last Name

NICOTRA

Suffix

DDS

Business Name

PAUL RUSSELL A NICOTRA DDS

Original Issue Date

05/15/2012

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

PALATINE

State

Zip

60067

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022