NICHOLAS DAVID KENNEDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

DAVID

Last Name

KENNEDY

Suffix

Business Name

NICHOLAS DAVID KENNEDY MD

Original Issue Date

01/18/2012

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

CHESTERTON

State

Zip

46304

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021