ANDREW STANTON NICKELS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055926

License Status

EXPIRED

Business

First Name

ANDREW

Middle

STANTON

Last Name

NICKELS

Suffix

Business Name

ANDREW STANTON NICKELS MD

Original Issue Date

06/24/2012

Effective Date

06/24/2012

Expiration Date

06/23/2013

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

10/07/2013