SCOTT R NYQUIST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

First Name

SCOTT R

Last Name

NYQUIST

Suffix

Business Name

SCOTT R NYQUIST MD

Original Issue Date

04/24/1985

Effective Date

05/10/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2023