NICHOLAS MICHAEL WHALEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084361

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

MICHAEL

Last Name

WHALEN

Business Name

NICHOLAS MICHAEL WHALEN MD

Original Issue Date

06/24/2024

Effective Date

06/24/2024

Expiration Date

06/23/2027

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/08/2024