NICOLE POLYAKOV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081822

License Status

ACTIVE

Business

Title

First Name

NICOLE

Last Name

POLYAKOV

Business Name

NICOLE POLYAKOV MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2026

City

BERWYN

State

Zip

60402

County

ADAMS

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/19/2024