NICHOLAS N NISSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027125

License Status

EXPIRED

Business

First Name

NICHOLAS N

Last Name

NISSEN

Suffix

Business Name

NICHOLAS N NISSEN MD

Original Issue Date

06/10/1991

Effective Date

06/10/1991

Expiration Date

06/30/1994

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006