KIMBERLY NICHOLE POWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

Title

First Name

KIMBERLY

Middle

NICHOLE

Last Name

POWELL

Business Name

KIMBERLY NICHOLE POWELL MD

Original Issue Date

06/27/2016

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023