NICOLE GABRIEL TENEGRA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

GABRIEL

Last Name

TENEGRA

Business Name

NICOLE GABRIEL TENEGRA MD

Original Issue Date

06/03/2020

Effective Date

05/10/2023

Expiration Date

07/31/2026

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2023