AMANDA MISTIQUE VICKERS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036174238

License Status

ACTIVE

Business

Title

First Name

AMANDA

Middle

MISTIQUE

Last Name

VICKERS

Business Name

AMANDA MISTIQUE VICKERS DO

Original Issue Date

03/19/2025

Effective Date

03/19/2025

Expiration Date

07/31/2026

City

NICHOLASVILLE

State

Zip

40356

Ever Disciplined

LastModifiedDate

03/19/2025