SARAH MARIE NISIVACO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078019

License Status

CANCELLED

Business

Title

First Name

SARAH

Middle

MARIE

Last Name

NISIVACO

Business Name

SARAH MARIE NISIVACO 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

Thoracic Surgery - Integrated

Ever Disciplined

LastModifiedDate

05/11/2021