NICOLE NOEL COSTELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

Title

First Name

NICOLE

Middle

NOEL

Last Name

COSTELLO

Business Name

NICOLE NOEL COSTELLO MD

Original Issue Date

08/25/2010

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

BOLINGBROOK

State

Zip

60440

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017