NICOLE ANNA KIEFFER 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

NICOLE

Middle

ANNA

Last Name

KIEFFER

Business Name

NICOLE ANNA KIEFFER

Original Issue Date

07/24/2008

Effective Date

04/21/2011

Expiration Date

07/31/2014

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014