NICOLE C GODINEZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060713

License Status

CANCELLED

Business

Title

First Name

NICOLE

Middle

Last Name

GODINEZ

Business Name

NICOLE C GODINEZ MD

Original Issue Date

08/24/2011

Effective Date

08/24/2011

Expiration Date

08/23/2014

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014