NICOLE EGHTESADI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084592

License Status

ACTIVE

Business

Title

First Name

NICOLE

Last Name

EGHTESADI

Business Name

NICOLE EGHTESADI MD

Original Issue Date

06/26/2024

Effective Date

06/26/2024

Expiration Date

06/25/2027

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

06/04/2024