NICOLE CHAPPELL ONTIVEROS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077363

License Status

EXPIRED

Business

Title

First Name

NICOLE

Middle

CHAPPELL

Last Name

ONTIVEROS

Business Name

NICOLE CHAPPELL ONTIVEROS MD

Original Issue Date

06/23/2021

Effective Date

06/23/2021

Expiration Date

06/22/2024

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/30/2024