NICOLE JEAN DANIELS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001393

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

JEAN

Last Name

DANIELS

Business Name

NICOLE JEAN DANIELS

Original Issue Date

06/22/2000

Effective Date

06/22/2000

Expiration Date

03/01/2002

City

WEST ALLIS

State

Zip

53227

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006