NICOLE CHRISTINE POWELL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

CHRISTINE

Last Name

POWELL

Business Name

NICOLE CHRISTINE POWELL

Original Issue Date

07/18/2008

Effective Date

08/17/2011

Expiration Date

07/31/2014

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014