NICOLE MARIE PETERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003809

License Status

ACTIVE

Business

First Name

NICOLE

Middle

MARIE

Last Name

PETERSON

Business Name

NICOLE MARIE PETERSON

Original Issue Date

08/02/2010

Effective Date

02/15/2026

Expiration Date

03/01/2028

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

02/15/2026