PETER F NICHOL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

Title

First Name

PETER

Middle

Last Name

NICHOL

Business Name

PETER F NICHOL MD

Original Issue Date

04/05/2013

Effective Date

06/20/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021