NICHOLAS P GUISTO III Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

Last Name

GUISTO III

Business Name

NICHOLAS P GUISTO III

Original Issue Date

07/26/2004

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

LANSING

State

Zip

60438

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023