SHENELLE NICOLE WILSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

Title

First Name

SHENELLE

Middle

NICOLE

Last Name

WILSON

Business Name

SHENELLE NICOLE WILSON MD

Original Issue Date

06/17/2022

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

ATLANTA

State

Zip

30318

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023