NICHOLE DEVON PHILLIPS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

Title

First Name

NICHOLE

Middle

DEVON

Last Name

PHILLIPS

Business Name

NICHOLE DEVON PHILLIPS DO

Original Issue Date

04/04/2025

Effective Date

04/04/2025

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/04/2025