NICOLE ELIZABETH BERGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001444

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

ELIZABETH

Last Name

BERGE

Business Name

NICOLE ELIZABETH BERGE

Original Issue Date

10/31/2000

Effective Date

10/31/2000

Expiration Date

03/01/2008

City

BATAVIA

State

Zip

60510

County

KANE

Ever Disciplined

LastModifiedDate

04/23/2008