NICHOLAS JACOB PRABHAKAR DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

JACOB

Last Name

PRABHAKAR

Business Name

NICHOLAS JACOB PRABHAKAR DO

Original Issue Date

09/10/2024

Effective Date

09/10/2024

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/10/2024