NICHOLAS J ROGERS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073849

License Status

CANCELLED

Business

Title

First Name

NICHOLAS

Middle

Last Name

ROGERS

Business Name

NICHOLAS J ROGERS DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/08/2019