NICHOLAS RICHARD WILSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002352

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

RICHARD

Last Name

WILSON

Business Name

NICHOLAS RICHARD WILSON

Original Issue Date

09/27/2004

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

04/01/2010