NICOLE A STASSEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033429

License Status

EXPIRED

Business

First Name

NICOLE

Middle

Last Name

STASSEN

Business Name

NICOLE A STASSEN

Original Issue Date

06/17/1995

Effective Date

06/17/1995

Expiration Date

06/23/2000

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006