NICOLE RENAE LAWSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

RENAE

Last Name

LAWSON

Business Name

NICOLE RENAE LAWSON

Original Issue Date

01/22/2015

Effective Date

01/22/2015

Expiration Date

03/01/2016

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

04/25/2016