THOMAS J NIELSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

First Name

THOMAS J

Last Name

NIELSEN

Suffix

Business Name

THOMAS J NIELSEN MD

Original Issue Date

12/11/2020

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60654

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2023