NICOLE J GALLOB Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002799

License Status

INACTIVE

Business

First Name

NICOLE

Middle

Last Name

GALLOB

Business Name

NICOLE J GALLOB

Original Issue Date

08/29/2006

Effective Date

08/29/2006

Expiration Date

03/01/2008

City

BURNSVILLE

State

Zip

55306

Ever Disciplined

LastModifiedDate

01/11/2011