NICHOLAS GEORGE SANSONE DO 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

NICHOLAS

Middle

GEORGE

Last Name

SANSONE

Suffix

Business Name

NICHOLAS GEORGE SANSONE DO

Original Issue Date

08/06/2008

Effective Date

06/29/2011

Expiration Date

07/31/2014

City

WEST LAFAYETTE

State

Zip

47906

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014