JAMES R NICHOLS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038805

License Status

CANCELLED

Business

First Name

JAMES

Middle

Last Name

NICHOLS

Suffix

Business Name

JAMES R NICHOLS MD

Original Issue Date

08/10/1998

Effective Date

08/10/1998

Expiration Date

08/09/2001

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006