NICOLE STACEY PAVLATOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

STACEY

Last Name

PAVLATOS

Suffix

Business Name

NICOLE STACEY PAVLATOS MD

Original Issue Date

12/18/2007

Effective Date

12/18/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017