THOMAS J NIELSEN MD 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

THOMAS J

Last Name

NIELSEN

Suffix

Business Name

THOMAS J NIELSEN MD

Original Issue Date

04/28/1986

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021