PETER WARNER NICHOLS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048150

License Status

CANCELLED

Business

First Name

PETER

Middle

WARNER

Last Name

NICHOLS

Suffix

Business Name

PETER WARNER NICHOLS MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

CHICAGO

State

Zip

60614

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006