NICOLE LYNN PHELPS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068111

License Status

CANCELLED

Business

Title

First Name

NICOLE

Middle

LYNN

Last Name

PHELPS

Business Name

NICOLE LYNN PHELPS DO

Original Issue Date

06/22/2016

Effective Date

06/22/2016

Expiration Date

06/21/2019

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/29/2016