NICHOLAS N NISSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036087027

License Status

NOT RENEWED

Business

First Name

NICHOLAS N

Last Name

NISSEN

Suffix

Business Name

NICHOLAS N NISSEN MD

Original Issue Date

08/02/1993

Effective Date

08/02/1993

Expiration Date

07/31/1999

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006