NICOLE POYTHRESS WATERS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036157809

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

POYTHRESS

Last Name

WATERS

Business Name

NICOLE POYTHRESS WATERS DO

Original Issue Date

07/23/2021

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

05/05/2023