NICHOLAS ANTONIO BURKE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

ANTONIO

Last Name

BURKE

Business Name

NICHOLAS ANTONIO BURKE DO

Original Issue Date

08/02/2023

Effective Date

08/02/2023

Expiration Date

07/31/2026

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/02/2023