NICHOLAS G STISO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

First Name

NICHOLAS G

Last Name

STISO

Business Name

NICHOLAS G STISO

Original Issue Date

10/22/1986

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023