License holder summary

NICOLE THERESA BAVUSO is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for NICOLE THERESA BAVUSO is Blackwood NJ 08012. This medical practitioner license is not current. The license was granted 06/12/2009 and expired on 06/17/2013.

Department of State

Board of Medicine

NICOLE THERESA BAVUSO
Graduate Medical Trainee
License number
MT195952
Date granted
06/12/2009
Date expires
06/17/2013
Class
Graduate Medical Trainee
Status
Inactive
Address
Blackwood NJ 08012
medicinepa.com
ID 37521157
LAST UPDATED 2026-04-04 01:15:27 UTC

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