NICHOLAS GRANDE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****42

License Status

ACTIVE

Business

First Name

NICHOLAS

Last Name

GRANDE

Business Name

NICHOLAS GRANDE

Original Issue Date

01/02/2024

Effective Date

01/02/2024

Expiration Date

03/01/2026

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025