NICOLAS FARES KETTANEH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059913

License Status

CANCELLED

Business

Title

First Name

NICOLAS

Middle

FARES

Last Name

KETTANEH

Business Name

NICOLAS FARES KETTANEH MD

Original Issue Date

06/27/2011

Effective Date

06/27/2011

Expiration Date

06/26/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/09/2011