NICHOLAS RAY VON HOLTEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****45

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

RAY

Last Name

VON HOLTEN

Business Name

NICHOLAS RAY VON HOLTEN

Original Issue Date

10/23/2019

Effective Date

01/02/2024

Expiration Date

03/01/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025