NICHOLAS IAN ELEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004682

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

IAN

Last Name

ELEY

Business Name

NICHOLAS IAN ELEY

Original Issue Date

06/10/2013

Effective Date

02/11/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018