JACK CLIFFORD NICHOLS II MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051459

License Status

NOT RENEWED

Business

First Name

JACK CLIFFORD

Last Name

NICHOLS II

Suffix

Business Name

JACK CLIFFORD NICHOLS II MD

Original Issue Date

08/15/1975

Effective Date

08/15/1975

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/20/2006