NICOLE POYTHRESS WATERS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

POYTHRESS

Last Name

WATERS

Business Name

NICOLE POYTHRESS WATERS DO

Original Issue Date

02/07/2022

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2023