BORISLAV MOMCHILOV NIKOLOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

BORISLAV

Middle

MOMCHILOV

Last Name

NIKOLOV

Suffix

Business Name

BORISLAV MOMCHILOV NIKOLOV MD

Original Issue Date

04/16/2015

Effective Date

01/02/2020

Expiration Date

09/30/2020

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021