MARK RYAN NIKKEL DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

MARK

Middle

RYAN

Last Name

NIKKEL

Suffix

Business Name

MARK RYAN NIKKEL DO

Original Issue Date

08/11/1999

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017