MARK WADE NIELSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015966

License Status

EXPIRED

Business

First Name

MARK

Middle

WADE

Last Name

NIELSEN

Suffix

Business Name

MARK WADE NIELSEN MD

Original Issue Date

06/15/1983

Effective Date

06/15/1983

Expiration Date

06/27/1985

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006