NICOLE SHELLY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007948

License Status

NOT RENEWED

Business

First Name

NICOLE

Last Name

SHELLY

Business Name

NICOLE SHELLY

Original Issue Date

09/14/2020

Effective Date

09/14/2020

Expiration Date

03/01/2022

City

TROY

State

Zip

48098

Ever Disciplined

LastModifiedDate

07/27/2022