NICHOLAS ANTHONY KUSNEZOV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

ANTHONY

Last Name

KUSNEZOV

Business Name

NICHOLAS ANTHONY KUSNEZOV MD

Original Issue Date

10/03/2018

Effective Date

07/01/2023

Expiration Date

07/31/2026

City

LA JOLLA

State

Zip

92037

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/01/2023