NICHOLAS WILLIAM DECKER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076609

License Status

EXPIRED

Business

Title

First Name

NICHOLAS

Middle

WILLIAM

Last Name

DECKER

Business Name

NICHOLAS WILLIAM DECKER MD

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2021

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/11/2022