NICOLAS FARES KETTANEH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

Title

First Name

NICOLAS

Middle

FARES

Last Name

KETTANEH

Business Name

NICOLAS FARES KETTANEH MD

Original Issue Date

01/21/2014

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

LA GRANGE

State

Zip

60525

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023