NICOLE M DALTON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****20

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

DALTON

Business Name

NICOLE M DALTON

Original Issue Date

12/10/2001

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

CLINTON

State

Zip

61727

County

DE WITT

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025