AVIDA NUBIA BUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

Title

First Name

AVIDA

Middle

NUBIA

Last Name

BUSSELL

Business Name

AVIDA NUBIA BUSSELL MD

Original Issue Date

08/25/2023

Effective Date

08/25/2023

Expiration Date

07/31/2026

City

HAZEL CREST

State

Zip

60429

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/25/2023