NICHOLETTE MONIQ MARTIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

NICHOLETTE MONIQ

Last Name

MARTIN

Business Name

NICHOLETTE MONIQ MARTIN

Original Issue Date

08/17/1992

Effective Date

08/17/1992

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60680

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006