ABBY NICOLE FREDRICKSON MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

INOPERATIVE

Business

Title

First Name

ABBY

Middle

NICOLE

Last Name

FREDRICKSON

Business Name

ABBY NICOLE FREDRICKSON MD

Original Issue Date

08/02/2023

Effective Date

08/02/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/02/2023