GLENN A NICKELE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095700

License Status

NOT RENEWED

Business

First Name

GLENN A

Last Name

NICKELE

Suffix

Business Name

GLENN A NICKELE MD

Original Issue Date

06/20/1997

Effective Date

06/20/1997

Expiration Date

07/31/2002

City

EDEN PRAIRIE

State

Zip

55347

County

MINNESOTA

Ever Disciplined

LastModifiedDate

10/09/2006