NICHOLAS MARCEL DE LA RUA 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

NICHOLAS

Middle

MARCEL

Last Name

DE LA RUA

Business Name

NICHOLAS MARCEL DE LA RUA MD

Original Issue Date

05/22/2025

Effective Date

05/22/2025

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/28/2025