KIERAN J NICHOLSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

KIERAN J

Last Name

NICHOLSON

Business Name

KIERAN J NICHOLSON

Original Issue Date

05/09/1988

Effective Date

05/09/1988

Expiration Date

07/31/1993

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020