JENNIFER LYNN NICHOLAS 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

First Name

JENNIFER

Middle

LYNN

Last Name

NICHOLAS

Suffix

Business Name

JENNIFER LYNN NICHOLAS MD

Original Issue Date

06/20/2007

Effective Date

06/06/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020