AVIDA NUBIA BUSSELL MD

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****48

ACTIVE

N

MD

AVIDA

NUBIA

BUSSELL

AVIDA NUBIA BUSSELL MD

08/25/2023

08/25/2023

07/31/2026

FRANKFORT

IL

60423

WILL

PRACTITIONER

II III IV V

N

02/24/2026