NIKKALYNN FOSTER DELAURENTIS DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045452

License Status

EXPIRED

Business

Title

First Name

NIKKALYNN

Middle

FOSTER

Last Name

DELAURENTIS

Business Name

NIKKALYNN FOSTER DELAURENTIS DO

Original Issue Date

11/06/2002

Effective Date

11/06/2002

Expiration Date

07/31/2005

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006