NINA KIYOMI SHEADE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

ACTIVE

Business

Title

First Name

NINA

Middle

KIYOMI

Last Name

SHEADE

Business Name

NINA KIYOMI SHEADE MD

Original Issue Date

10/18/2021

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2023