NIKOLAS SANDQUIST WILDE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****96

License Status

ACTIVE

Business

First Name

NIKOLAS

Middle

SANDQUIST

Last Name

WILDE

Business Name

NIKOLAS SANDQUIST WILDE

Original Issue Date

05/15/2024

Effective Date

01/04/2026

Expiration Date

03/01/2028

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/04/2026