NICHOLAS R IDLE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****79

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

Last Name

IDLE

Business Name

NICHOLAS R IDLE

Original Issue Date

11/28/2011

Effective Date

01/18/2026

Expiration Date

03/01/2028

City

DECATUR

State

Zip

62526

County

MACON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/18/2026