NICHOLE JOY MIROCHA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

NICHOLE

Middle

JOY

Last Name

MIROCHA

Suffix

Business Name

NICHOLE JOY MIROCHA DO

Original Issue Date

12/06/2006

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023