NICOLE M WAKIM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

WAKIM

Business Name

NICOLE M WAKIM

Original Issue Date

01/10/2006

Effective Date

01/10/2006

Expiration Date

07/31/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008