HENRYK JAN NIKICICZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

Title

First Name

HENRYK

Middle

JAN

Last Name

NIKICICZ

Business Name

HENRYK JAN NIKICICZ MD

Original Issue Date

06/29/2024

Effective Date

06/29/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026