KIM R NICKELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

KIM R

Last Name

NICKELSON

Suffix

Business Name

KIM R NICKELSON MD

Original Issue Date

06/14/1984

Effective Date

06/14/1984

Expiration Date

07/31/1990

City

OAK BROOK

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017