NICOLE M WAKIM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115049

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

WAKIM

Business Name

NICOLE M WAKIM

Original Issue Date

12/29/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

06/08/2011