NICHOLAS RYAN PETRE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

RYAN

Last Name

PETRE

Business Name

NICHOLAS RYAN PETRE MD

Original Issue Date

05/13/2021

Effective Date

05/26/2023

Expiration Date

07/31/2026

City

EAST MOLINE

State

Zip

61244

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/26/2023