NICOLE ANN MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002642

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

ANN

Last Name

MILLER

Business Name

NICOLE ANN MILLER

Original Issue Date

10/25/2005

Effective Date

01/08/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012