NSIKAN MIANEAEKERE ST. MARTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

Title

First Name

NSIKAN

Middle

MIANEAEKERE

Last Name

ST. MARTIN

Business Name

NSIKAN MIANEAEKERE ST. MARTIN MD

Original Issue Date

10/24/2022

Effective Date

08/12/2023

Expiration Date

07/31/2026

City

FAIRVIEW HEIGHTS

State

Zip

62208

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/12/2023