NICOLE BRIANNE STAHL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****08

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

BRIANNE

Last Name

STAHL

Business Name

NICOLE BRIANNE STAHL

Original Issue Date

08/29/2017

Effective Date

01/28/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60642

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022