NICOLAS BENJAMIN KREPOSTMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

Title

First Name

NICOLAS

Middle

BENJAMIN

Last Name

KREPOSTMAN

Business Name

NICOLAS BENJAMIN KREPOSTMAN MD

Original Issue Date

05/12/2021

Effective Date

05/12/2021

Expiration Date

07/31/2023

City

MAYWOOD

State

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023