NICOLE M WAKIM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046096

License Status

EXPIRED

Business

First Name

NICOLE

Middle

Last Name

WAKIM

Business Name

NICOLE M WAKIM

Original Issue Date

06/22/2003

Effective Date

06/22/2003

Expiration Date

06/30/2006

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006