NICHELL D TIDWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

NICHELL D

Last Name

TIDWELL

Suffix

Business Name

NICHELL D TIDWELL MD

Original Issue Date

11/18/1994

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023