NICOLE K BEAUVAIS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****40

License Status

INOPERATIVE

Business

First Name

NICOLE

Middle

Last Name

BEAUVAIS

Business Name

NICOLE K BEAUVAIS

Original Issue Date

01/22/2004

Effective Date

02/19/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018