NIA FEASTER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077469

License Status

EXPIRED

Business

First Name

NIA

Last Name

FEASTER

Business Name

NIA FEASTER

Original Issue Date

06/24/2021

Effective Date

06/24/2021

Expiration Date

06/23/2024

City

CHICAGO

State

Zip

60637

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/30/2024