NICOLE CHRISTINE POWELL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121500

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

CHRISTINE

Last Name

POWELL

Business Name

NICOLE CHRISTINE POWELL

Original Issue Date

07/16/2008

Effective Date

08/17/2011

Expiration Date

07/31/2014

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

11/17/2014