KENNETH RICHARD NISSIM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036170811

License Status

ACTIVE

Business

Title

First Name

KENNETH

Middle

RICHARD

Last Name

NISSIM

Business Name

KENNETH RICHARD NISSIM MD

Original Issue Date

06/28/2024

Effective Date

06/28/2024

Expiration Date

07/31/2026

City

KEY BISCAYNE

State

Zip

33149

Ever Disciplined

LastModifiedDate

06/26/2024