NIKI MOSCANDREW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

NIKI

Last Name

MOSCANDREW

Suffix

Business Name

NIKI MOSCANDREW MD

Original Issue Date

08/16/1999

Effective Date

08/16/1999

Expiration Date

07/31/2008

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011