NICHOLAS PAUL FORD - Physician Assistant License in Iowa | # 085002386

NICHOLAS PAUL FORD

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002386

License Status

INACTIVE

Business

N

First Name

NICHOLAS

Middle

PAUL

Last Name

FORD

Business Name

NICHOLAS PAUL FORD

Original Issue Date

10/15/2004

Effective Date

10/15/2004

Expiration Date

03/01/2006

State

IA

Ever Disciplined

N

LastModifiedDate

10/09/2006