NICOLE SANDRA DECOUDRES Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004485

License Status

ACTIVE

Business

First Name

NICOLE

Middle

SANDRA

Last Name

DECOUDRES

Business Name

NICOLE SANDRA DECOUDRES

Original Issue Date

10/04/2012

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025