NICOLE DENISE MAKRAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

DENISE

Last Name

MAKRAM

Suffix

Business Name

NICOLE DENISE MAKRAM MD

Original Issue Date

07/13/1999

Effective Date

07/13/1999

Expiration Date

07/31/2002

City

CENTREVILLE

State

Zip

62207

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006