ROBERT JOSEPH NICKODEM JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

ROBERT JOSEPH

Last Name

NICKODEM JR

Suffix

Business Name

ROBERT JOSEPH NICKODEM JR MD

Original Issue Date

02/10/1982

Effective Date

02/10/1982

Expiration Date

07/31/1987

City

MENTOR

State

Zip

44060

County

OHIO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006