NICHOLAS RYAN MATHENIA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060211

License Status

CANCELLED

Business

Title

First Name

NICHOLAS

Middle

RYAN

Last Name

MATHENIA

Business Name

NICHOLAS RYAN MATHENIA DO

Original Issue Date

06/24/2013

Effective Date

06/24/2013

Expiration Date

06/23/2014

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

03/24/2014