NICHOLAS FORD CALLAHAN MD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

FORD

Last Name

CALLAHAN

Business Name

NICHOLAS FORD CALLAHAN MD

Original Issue Date

08/02/2018

Effective Date

07/18/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2024