NICOLE BETENIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

Title

First Name

NICOLE

Last Name

BETENIA

Business Name

NICOLE BETENIA MD

Original Issue Date

06/03/2020

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

SAN RAFAEL

State

Zip

94901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023