HANNAH RAE NUCKOLS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

ACTIVE

Business

Title

First Name

HANNAH

Middle

RAE

Last Name

NUCKOLS

Business Name

HANNAH RAE NUCKOLS DO

Original Issue Date

06/25/2015

Effective Date

07/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/28/2023