NICHOLE RACQUEL LEWIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

NICHOLE

Middle

RACQUEL

Last Name

LEWIS

Business Name

NICHOLE RACQUEL LEWIS MD

Original Issue Date

01/14/2024

Effective Date

01/14/2024

Expiration Date

07/31/2026

City

CRESTWOOD

State

Zip

60418

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2024