NICHOLAS G STISO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

CANCELLED

Business

First Name

NICHOLAS G

Last Name

STISO

Business Name

NICHOLAS G STISO

Original Issue Date

07/17/1987

Effective Date

07/17/1987

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60609

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020