NICOLE MACKIE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

Title

DDS

First Name

NICOLE

Last Name

MACKIE

Business Name

NICOLE MACKIE DDS

Original Issue Date

10/02/2020

Effective Date

10/02/2020

Expiration Date

01/31/2022

City

LAS VEGAS

State

Zip

89147

County

CLARK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022