SHANICKA NATE WILLIAMS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

SHANICKA

Middle

NATE

Last Name

WILLIAMS

Suffix

Business Name

SHANICKA NATE WILLIAMS MD

Original Issue Date

08/04/2011

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

SACRAMENTO

State

Zip

95841

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021