ALICE TABISA NANYONGA 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

ALICE

Middle

TABISA

Last Name

NANYONGA

Business Name

ALICE TABISA NANYONGA MD

Original Issue Date

01/19/2024

Effective Date

01/19/2024

Expiration Date

07/31/2026

City

ELLICOTTVILLE

State

Zip

14731

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/19/2024