Complaint Gateway | North Carolina Medical Board

Healthcare Professionals Reporting Form

Contact Information

Your Information

Are you an NCMB Licensee?:

Use the Search for Practitioner button to lookup Licensees in North Carolina.

Name:

Address 1:

Address 2:

Zip, City, State:

Daytime Phone Number:

Other Phone Number:

Your Email Address:

I wish to anonymously report this complaint

You will receive no more communications from the North Carolina Medical Board. You will not be able to inquire for any information regarding the case. I Agree

Please be advised that if your issue regards patient care then we cannot guarantee the complaint will remain anonymous.

Patient Information

Patient's Full Name (if different from complainant):

Date of Birth:

Age:

Relationship to Patient:

Relationship Other:

NOTE: Top 100 results displayed. If desired result is not found, please refine your search.

Name	License #	Type	Status		Specialty

Your Information

Patient Information

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