BRENDA JEAN NICHOLS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002520

License Status

NOT RENEWED

Business

First Name

BRENDA

Middle

JEAN

Last Name

NICHOLS

Business Name

BRENDA JEAN NICHOLS

Original Issue Date

08/04/2005

Effective Date

08/04/2005

Expiration Date

03/01/2008

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008