NICOLE MARIE DAVIS DO 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

NICOLE

Middle

MARIE

Last Name

DAVIS

Business Name

NICOLE MARIE DAVIS DO

Original Issue Date

05/03/2019

Effective Date

05/03/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021