NICHOLAS RYAN PETRE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072248

License Status

CANCELLED

Business

Title

First Name

NICHOLAS

Middle

RYAN

Last Name

PETRE

Business Name

NICHOLAS RYAN PETRE MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/02/2018