NICHOLAS R WALTERS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004177

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

Last Name

WALTERS

Business Name

NICHOLAS R WALTERS

Original Issue Date

10/03/2011

Effective Date

01/09/2026

Expiration Date

03/01/2028

City

ROMEOVILLE

State

Zip

60446

County

WILL

Ever Disciplined

LastModifiedDate

01/09/2026