ELIOT M NISSENBAUM DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135963

License Status

ACTIVE

Business

Title

First Name

ELIOT

Middle

Last Name

NISSENBAUM

Business Name

ELIOT M NISSENBAUM DO

Original Issue Date

07/17/2014

Effective Date

07/17/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

07/17/2023