NICOLAS S ANDERSON DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****38

License Status

ACTIVE

Business

First Name

NICOLAS

Middle

Last Name

ANDERSON

Suffix

DPM

Business Name

NICOLAS S ANDERSON DPM

Original Issue Date

01/31/2007

Effective Date

01/07/2025

Expiration Date

01/31/2027

City

RIVERSIDE

State

Zip

60546

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025