NICOLE ANN MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

ANN

Last Name

MILLER

Business Name

NICOLE ANN MILLER

Original Issue Date

08/09/2006

Effective Date

01/08/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012