NICHOLAS ALAN SHEPARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

Title

First Name

NICHOLAS

Middle

ALAN

Last Name

SHEPARD

Business Name

NICHOLAS ALAN SHEPARD MD

Original Issue Date

04/09/2020

Effective Date

04/09/2020

Expiration Date

07/31/2023

City

NEW YORK

State

Zip

10016

County

NEW YORK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023