NICHOLAS TYLER WALSH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007156

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

TYLER

Last Name

WALSH

Business Name

NICHOLAS TYLER WALSH

Original Issue Date

08/09/2019

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022