NICKOLAS PETER MASTORES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

NICKOLAS PETER

Last Name

MASTORES

Suffix

Business Name

NICKOLAS PETER MASTORES MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

SKOKIE

State

Zip

60076

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/24/2007

Case Number

1985000564

Action

Revocation

Discipline Start Date

01/27/1989