Medical Practice Licenses in Nebraska

License number
Nebraska CA-GFE63801-B
Address
Nebraska
Category
Medicine
Issued Date
May 3, 1997
Effective Date
Nov 22, 2004
Expiration Date
Jun 1, 1997
Type
Physician Locum Tenens
License number
Nebraska CA-GFE63801-A
Address
Nebraska
Category
Medicine
Issued Date
Jan 1, 1997
Effective Date
Nov 22, 2004
Expiration Date
Jan 12, 1997
Type
Physician Locum Tenens
License number
Nebraska 6414
Address
Nebraska
Category
Medicine
Issued Date
Sep 8, 2010
Effective Date
Jul 11, 2012
Expiration Date
Jul 1, 2012
Type
Temporary Educational Permit
License number
Nebraska 4853
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 2003
Effective Date
Dec 12, 2005
Expiration Date
Jul 1, 2006
Type
Temporary Educational Permit
License number
Nebraska 3965
Address
Nebraska
Category
Medicine
Issued Date
Dec 5, 2000
Effective Date
Oct 1, 2003
Expiration Date
Oct 1, 2003
Type
Backup PA Supervisor
License number
Nebraska 577
Address
Nebraska
Category
Medicine
Issued Date
Feb 4, 2008
Effective Date
Oct 3, 2016
Expiration Date
Oct 1, 2016
Type
Osteopathic Physician & Surgeon
License number
Nebraska 1966
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 1986
Effective Date
Jul 1, 1991
Type
Temporary Educational Permit
License number
Nebraska 6285
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 2010
Effective Date
Jul 2, 2013
Expiration Date
Jul 1, 2013
Type
Temporary Educational Permit
License number
Nebraska 2473
Address
Nebraska
Category
Medicine
Issued Date
Apr 16, 1998
Effective Date
Oct 1, 2003
Expiration Date
Oct 1, 2003
Type
Backup PA Supervisor
License number
Nebraska 2800
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 1992
Effective Date
Jul 2, 1993
Type
Temporary Educational Permit
License number
Nebraska 953
Address
Nebraska
Category
Medicine
Issued Date
Jun 26, 2000
Effective Date
Oct 6, 2009
Expiration Date
Oct 1, 2009
Type
Physician Assistant Supervisor
License number
Nebraska 2012
Address
Nebraska
Category
Medicine
Issued Date
Oct 23, 1997
Effective Date
Oct 1, 1998
Expiration Date
Oct 1, 1998
Type
Backup PA Supervisor
License number
Nebraska 4032
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 1999
Effective Date
Jul 30, 2002
Expiration Date
Jul 1, 2003
Type
Temporary Educational Permit
License number
Nebraska 4898
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 2003
Effective Date
Jul 2, 2007
Expiration Date
Jul 1, 2007
Type
Temporary Educational Permit
License number
Nebraska SD-5696-A
Address
Nebraska
Category
Medicine
Issued Date
Jan 9, 2012
Effective Date
Jan 16, 2012
Expiration Date
Jan 15, 2012
Type
Physician Locum Tenens
License number
Nebraska 6872
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 2012
Effective Date
Aug 16, 2013
Expiration Date
Jul 1, 2014
Type
Temporary Educational Permit
License number
Nebraska # 421
Address
5156 Avenue Cir, Omaha, NE 68135
Category
Medical Practice
Type
Specialist