NAN O WALICKI Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

NAN

Middle

Last Name

WALICKI

Business Name

NAN O WALICKI

Original Issue Date

04/06/2005

Effective Date

04/19/2023

Expiration Date

07/31/2026

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/19/2023