NICOLE STACEY PAVLATOS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047095

License Status

EXPIRED

Business

First Name

NICOLE

Middle

STACEY

Last Name

PAVLATOS

Suffix

Business Name

NICOLE STACEY PAVLATOS MD

Original Issue Date

08/30/2007

Effective Date

08/30/2007

Expiration Date

10/06/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

10/17/2007