NICHOLAS RICHARD WILSON 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

NICHOLAS

Middle

RICHARD

Last Name

WILSON

Business Name

NICHOLAS RICHARD WILSON

Original Issue Date

01/27/2005

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

04/07/2008