MATEO NICHOLSON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074919

License Status

EXPIRED

Business

Title

First Name

MATEO

Last Name

NICHOLSON

Business Name

MATEO NICHOLSON DO

Original Issue Date

06/25/2019

Effective Date

06/25/2019

Expiration Date

06/24/2020

City

PARK RIDGE

State

Zip

60068

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

11/19/2020