NICOLE E BACK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005861

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

BACK

Business Name

NICOLE E BACK

Original Issue Date

06/30/2016

Effective Date

01/15/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

01/15/2026