NICOLE ALICE MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

ALICE

Last Name

MILLER

Business Name

NICOLE ALICE MILLER

Original Issue Date

02/24/2015

Effective Date

02/18/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018