NICHOLAS MICHAEL WEBER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073313

License Status

CANCELLED

Business

Title

First Name

NICHOLAS

Middle

MICHAEL

Last Name

WEBER

Business Name

NICHOLAS MICHAEL WEBER DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/13/2018