AVIDA NUBIA BUSSELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

Title

First Name

AVIDA

Middle

NUBIA

Last Name

BUSSELL

Business Name

AVIDA NUBIA BUSSELL MD

Original Issue Date

08/07/2021

Effective Date

08/07/2021

Expiration Date

07/31/2023

City

FRANKFORT

State

Zip

60423

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023