NICHELL D TIDWELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025241

License Status

EXPIRED

Business

First Name

NICHELL D

Last Name

TIDWELL

Suffix

Business Name

NICHELL D TIDWELL MD

Original Issue Date

05/29/1990

Effective Date

05/29/1990

Expiration Date

06/22/1993

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006