NIZAR MOHAMMAD KHERALLAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

Title

First Name

NIZAR

Middle

MOHAMMAD

Last Name

KHERALLAH

Business Name

NIZAR MOHAMMAD KHERALLAH MD

Original Issue Date

05/23/2016

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021