NICOLE RENEE POUPPIRT MD 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

NICOLE

Middle

RENEE

Last Name

POUPPIRT

Business Name

NICOLE RENEE POUPPIRT MD

Original Issue Date

09/18/2018

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023