NICOLAS F M PORTA 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

Title

First Name

NICOLAS

Middle

F M

Last Name

PORTA

Business Name

NICOLAS F M PORTA MD

Original Issue Date

07/12/1999

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2023