ALEXANDRIA NICOLE RUZICKA Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****48

License Status

INOPERATIVE

Business

First Name

ALEXANDRIA

Middle

NICOLE

Last Name

RUZICKA

Business Name

ALEXANDRIA NICOLE RUZICKA

Original Issue Date

03/14/2014

Effective Date

02/27/2018

Expiration Date

03/01/2020

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

12/18/2019