NICOLE LORENE FYIE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

LORENE

Last Name

FYIE

Business Name

NICOLE LORENE FYIE MD

Original Issue Date

03/28/2013

Effective Date

07/19/2023

Expiration Date

07/31/2026

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2023