NICHOLAS STEPHEN SHEPPARD - Physician Assistant License in Illinois | # 085000079

NICHOLAS STEPHEN SHEPPARD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000079

License Status

NOT RENEWED

Business

N

First Name

NICHOLAS STEPHEN

Last Name

SHEPPARD

Business Name

NICHOLAS STEPHEN SHEPPARD

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

11/05/1984

State

IL

Ever Disciplined

N

LastModifiedDate

09/26/2006