ALLISON GRACE MCNICKLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

ALLISON

Middle

GRACE

Last Name

MCNICKLE

Business Name

ALLISON GRACE MCNICKLE MD

Original Issue Date

04/25/2013

Effective Date

05/26/2014

Expiration Date

07/31/2017

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017