NICOLE ELIZABETH DECREDICO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068309

License Status

CANCELLED

Business

Title

First Name

NICOLE

Middle

ELIZABETH

Last Name

DECREDICO

Business Name

NICOLE ELIZABETH DECREDICO MD

Original Issue Date

06/23/2016

Effective Date

06/23/2016

Expiration Date

06/22/2019

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/11/2016