NICOLAS MANUEL LOPEZ HISIJOS DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151329

License Status

NOT RENEWED

Business

Title

First Name

NICOLAS

Middle

MANUEL

Last Name

LOPEZ HISIJOS

Business Name

NICOLAS MANUEL LOPEZ HISIJOS DO

Original Issue Date

12/10/2019

Effective Date

06/12/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023