NICOLE ELAINE FIFER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****30

License Status

INOPERATIVE

Business

First Name

NICOLE

Middle

ELAINE

Last Name

FIFER

Business Name

NICOLE ELAINE FIFER

Original Issue Date

10/31/2011

Effective Date

03/01/2012

Expiration Date

03/01/2014

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

11/05/2013