NICHOLE SUZANNE LUPEI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056508

License Status

CANCELLED

Business

Title

First Name

NICHOLE

Middle

SUZANNE

Last Name

LUPEI

Business Name

NICHOLE SUZANNE LUPEI DO

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/06/2009