KRISTINE M NICOLETTO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****57

License Status

ACTIVE

Business

First Name

KRISTINE

Middle

Last Name

NICOLETTO

Business Name

KRISTINE M NICOLETTO

Original Issue Date

10/07/2004

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

VILLA PARK

State

Zip

60181

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025