NICOLE M SKALOUD - Physician Assistant License in Illinois | # 085002420

NICOLE M SKALOUD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002420

License Status

NOT RENEWED

Business

N

First Name

NICOLE

Middle

M

Last Name

SKALOUD

Business Name

NICOLE M SKALOUD

Original Issue Date

11/30/2004

Effective Date

11/30/2004

Expiration Date

03/01/2006

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006