NICHOLAS ALAN SHEPARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036152449

License Status

NOT RENEWED

Business

Title

First Name

NICHOLAS

Middle

ALAN

Last Name

SHEPARD

Business Name

NICHOLAS ALAN SHEPARD MD

Original Issue Date

04/03/2020

Effective Date

04/03/2020

Expiration Date

07/31/2023

City

NEW YORK

State

Zip

10016

Ever Disciplined

LastModifiedDate

11/30/2023