NICHOLAS GURGANIOUS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007041

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Last Name

GURGANIOUS

Business Name

NICHOLAS GURGANIOUS

Original Issue Date

04/18/2019

Effective Date

01/21/2020

Expiration Date

03/01/2022

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/27/2022