NICOLE MARIE FOX Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006038

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

MARIE

Last Name

FOX

Business Name

NICOLE MARIE FOX

Original Issue Date

10/06/2016

Effective Date

10/06/2016

Expiration Date

03/01/2018

City

CALDWELL

State

Zip

07006

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

05/10/2018