NICOLE TANIA LOWE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

NICOLE

Middle

TANIA

Last Name

LOWE

Business Name

NICOLE TANIA LOWE MD

Original Issue Date

11/05/2010

Effective Date

11/05/2010

Expiration Date

07/31/2011

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011