NICHOLAS ANTHONY KUSNEZOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001108

License Status

NOT RENEWED

Business

Title

First Name

NICHOLAS

Middle

ANTHONY

Last Name

KUSNEZOV

Business Name

NICHOLAS ANTHONY KUSNEZOV MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

09/30/2016

City

LA JOLLA

State

Zip

92037

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

03/09/2017