STACEY NICOLE NICKOLOFF DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108986

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

NICOLE

Last Name

NICKOLOFF

Suffix

Business Name

STACEY NICOLE NICKOLOFF DO

Original Issue Date

04/10/2003

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021