NICHOLAS IAN KIRCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

Title

First Name

NICHOLAS

Middle

IAN

Last Name

KIRCH

Business Name

NICHOLAS IAN KIRCH MD

Original Issue Date

09/03/2020

Effective Date

09/03/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023