Medical Practice Licenses in Nebraska

License number
Nebraska 1646
Address
Nebraska
Category
Medicine
Issued Date
May 4, 1993
Effective Date
Oct 2, 1995
Type
Backup PA Supervisor
License number
Nebraska 2155
Address
Nebraska
Category
Medicine
Issued Date
Feb 15, 1996
Effective Date
Dec 12, 1997
Type
Backup PA Supervisor
License number
Nebraska 716
Address
Nebraska
Category
Medicine
Issued Date
Sep 5, 1989
Effective Date
Jan 16, 1991
Type
Backup PA Supervisor
License number
Nebraska 715
Address
Nebraska
Category
Medicine
Issued Date
Apr 15, 1991
Effective Date
Oct 30, 1998
Expiration Date
Oct 1, 1999
Type
Backup PA Supervisor
License number
Nebraska 2220
Address
Nebraska
Category
Medicine
Issued Date
Feb 14, 2008
Effective Date
Oct 6, 2009
Expiration Date
Oct 1, 2009
Type
Physician Assistant Supervisor
License number
Nebraska 1275
Address
Nebraska
Category
Medicine
Issued Date
Nov 22, 2002
Effective Date
Aug 18, 2005
Expiration Date
Oct 1, 2005
Type
Physician Assistant Supervisor
License number
Nebraska 2148
Address
Nebraska
Category
Medicine
Issued Date
Mar 7, 1997
Effective Date
Oct 2, 1997
Type
Backup PA Supervisor
License number
Nebraska CO-15130-D
Address
Nebraska
Category
Medicine
Issued Date
Jan 22, 1991
Effective Date
Nov 22, 2004
Expiration Date
Jan 23, 1991
Type
Physician Locum Tenens
License number
Nebraska CO-15130-C
Address
Nebraska
Category
Medicine
Issued Date
Jan 15, 1991
Effective Date
Nov 22, 2004
Expiration Date
Jan 16, 1991
Type
Physician Locum Tenens
License number
Nebraska CO-15130-B
Address
Nebraska
Category
Medicine
Issued Date
Jan 8, 1991
Effective Date
Nov 22, 2004
Expiration Date
Jan 9, 1991
Type
Physician Locum Tenens
License number
Nebraska CO-15130-E
Address
Nebraska
Category
Medicine
Issued Date
Jan 29, 1991
Effective Date
Nov 22, 2004
Expiration Date
Jan 30, 1991
Type
Physician Locum Tenens
License number
Nebraska 3967
Address
Nebraska
Category
Medicine
Issued Date
Dec 6, 2000
Effective Date
Dec 27, 2002
Expiration Date
Oct 1, 2003
Type
Backup PA Supervisor
License number
Nebraska 3057
Address
Nebraska
Category
Medicine
Issued Date
Mar 9, 1999
Effective Date
Jul 28, 2000
Expiration Date
Oct 1, 2001
Type
Backup PA Supervisor
License number
Nebraska 3824
Address
Nebraska
Category
Medicine
Issued Date
Sep 7, 2000
Effective Date
Mar 2, 2001
Expiration Date
Oct 1, 2001
Type
Backup PA Supervisor
License number
Nebraska 4161
Address
Nebraska
Category
Medicine
Issued Date
May 2, 2001
Effective Date
Oct 1, 2003
Expiration Date
Oct 1, 2003
Type
Backup PA Supervisor
License number
Nebraska 3750
Address
Nebraska
Category
Medicine
Issued Date
Jul 1, 1997
Effective Date
Aug 20, 1998
Expiration Date
Jul 1, 1999
Type
Temporary Educational Permit
License number
Nebraska 4495
Address
Nebraska
Category
Medicine
Issued Date
Oct 4, 2001
Effective Date
Oct 1, 2003
Expiration Date
Oct 1, 2003
Type
Backup PA Supervisor