NICOLE S PERRY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

NICOLE S

Last Name

PERRY

Business Name

NICOLE S PERRY

Original Issue Date

03/22/1993

Effective Date

03/22/1993

Expiration Date

07/31/1996

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006