NICHELL D TIDWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

NICHELL D

Last Name

TIDWELL

Suffix

Business Name

NICHELL D TIDWELL MD

Original Issue Date

04/16/2007

Effective Date

06/25/2008

Expiration Date

07/31/2011

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020