NICHOLAS MARCEL DE LA RUA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159353

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

MARCEL

Last Name

DE LA RUA

Business Name

NICHOLAS MARCEL DE LA RUA MD

Original Issue Date

02/04/2022

Effective Date

05/10/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2023