NICHOLAS ANTHONY BORAGGINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

NICHOLAS

Middle

ANTHONY

Last Name

BORAGGINA

Business Name

NICHOLAS ANTHONY BORAGGINA MD

Original Issue Date

08/15/2016

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021