RICHARD SCOT NICKLAS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

ACTIVE

Business

First Name

RICHARD SCOT

Last Name

NICKLAS

Business Name

RICHARD SCOT NICKLAS

Original Issue Date

08/12/1985

Effective Date

09/26/2024

Expiration Date

09/30/2027

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2024