KIMBERLY NICOLE KOLDENHOVEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

NICOLE

Last Name

KOLDENHOVEN

Business Name

KIMBERLY NICOLE KOLDENHOVEN

Original Issue Date

08/26/2008

Effective Date

03/06/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

07/06/2015