THOMAS E NIELSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012571

License Status

EXPIRED

Business

First Name

THOMAS E

Last Name

NIELSEN

Suffix

Business Name

THOMAS E NIELSEN MD

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

06/29/1983

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006