ANDRE NICHOLAS DAVIES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

Title

First Name

ANDRE

Middle

NICHOLAS

Last Name

DAVIES

Business Name

ANDRE NICHOLAS DAVIES MD

Original Issue Date

06/12/2018

Effective Date

06/12/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021