Illinois Department of Financial and Professional Regulation   Illinois Department of Financial and Professional Regulation
 

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Contact
Contact Information
NameCity/State/ZipDBA
Colleen McNicholas DOFairview heights, IL 62208 

License
License Information
License NumberDescription StatusFirst Effective DateEffective DateExpiration DateEver Disciplined
036149897LICENSED PHYSICIAN AND SURGEONACTIVE06/21/201905/14/202007/31/2023N

Other Licenses
Other Licenses
License NumberDescription StatusFirst Effective DateEffective DateExpiration DateEver Disciplined
33*****54LICENSED PHYSICIAN CONTROLLED SUBSTANCE
(Schedules II III IV V )
ACTIVE07/30/201907/30/201909/30/2020N

Generated on:  7/7/2020 10:24:06 AM