NICHOLE ELIZABETH TWEDT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****15

License Status

NOT RENEWED

Business

First Name

NICHOLE

Middle

ELIZABETH

Last Name

TWEDT

Business Name

NICHOLE ELIZABETH TWEDT

Original Issue Date

10/19/2005

Effective Date

10/19/2005

Expiration Date

03/01/2008

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2007