NICHOLAS R WALTERS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

Last Name

WALTERS

Business Name

NICHOLAS R WALTERS

Original Issue Date

11/29/2011

Effective Date

01/09/2026

Expiration Date

03/01/2028

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/09/2026