NICOLE D EDISON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

Last Name

EDISON

Business Name

NICOLE D EDISON MD

Original Issue Date

07/02/2021

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

NEW YORK

State

Zip

10025

County

NEW YORK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023