NICHOLAS ALLEN MARTIN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072843

License Status

EXPIRED

Business

Title

First Name

NICHOLAS

Middle

ALLEN

Last Name

MARTIN

Business Name

NICHOLAS ALLEN MARTIN DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022