NICOLE FOBI-NUNGA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

NICOLE

Last Name

FOBI-NUNGA

Business Name

NICOLE FOBI-NUNGA

Original Issue Date

01/31/2020

Effective Date

05/14/2023

Expiration Date

07/31/2026

City

ROCK ISLAND

State

Zip

61201

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/14/2023