LYNN M NICOLAISEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****48

License Status

NOT RENEWED

Business

First Name

LYNN

Middle

Last Name

NICOLAISEN

Business Name

LYNN M NICOLAISEN

Original Issue Date

10/01/2010

Effective Date

04/03/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016