NICHOLAS STUART LYSAK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

STUART

Last Name

LYSAK

Business Name

NICHOLAS STUART LYSAK

Original Issue Date

05/30/2023

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2023