NICOLE A STASSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103614

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

STASSEN

Business Name

NICOLE A STASSEN

Original Issue Date

10/06/2000

Effective Date

10/06/2000

Expiration Date

07/31/2002

City

LOUISVILLE

State

Zip

40203

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/09/2006