NICOLE L PIEDIMONTE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004973

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

PIEDIMONTE

Business Name

NICOLE L PIEDIMONTE

Original Issue Date

01/14/2014

Effective Date

03/02/2018

Expiration Date

03/01/2020

City

ELGIN

State

Zip

60120

County

KANE

Ever Disciplined

LastModifiedDate

11/24/2020