JACQUELYN D NICHOLS - Physician Assistant License in Illinois | # 085006030

JACQUELYN D NICHOLS

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006030

License Status

NOT RENEWED

Business

N

First Name

JACQUELYN

Middle

D

Last Name

NICHOLS

Business Name

JACQUELYN D NICHOLS

Original Issue Date

10/04/2016

Effective Date

02/20/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020