NICOLE PETERSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009025

License Status

NOT RENEWED

Business

First Name

NICOLE

Last Name

PETERSON

Business Name

NICOLE PETERSON

Original Issue Date

07/13/2022

Effective Date

07/13/2022

Expiration Date

03/01/2024

City

SCHERERVILLE

State

Zip

46375

Ever Disciplined

LastModifiedDate

02/05/2025