NICOLE D CANALEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

CANALEY

Suffix

Business Name

NICOLE D CANALEY MD

Original Issue Date

08/02/2007

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

GRANITE CITY

State

Zip

62040

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021