NICOLE MARIE ROACH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008719

License Status

ACTIVE

Business

First Name

NICOLE

Middle

MARIE

Last Name

ROACH

Business Name

NICOLE MARIE ROACH

Original Issue Date

10/22/2021

Effective Date

02/16/2024

Expiration Date

03/01/2026

City

JOLIET

State

Zip

60435

County

WILL

Ever Disciplined

LastModifiedDate

12/03/2025