NICOLE R MATHEW Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****92

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

MATHEW

Business Name

NICOLE R MATHEW

Original Issue Date

09/24/2013

Effective Date

02/19/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018