KIERAN J NICHOLSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

KIERAN J

Last Name

NICHOLSON

Business Name

KIERAN J NICHOLSON

Original Issue Date

05/12/1992

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023