NICHOLAS STACHOWIAK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008608

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Last Name

STACHOWIAK

Business Name

NICHOLAS STACHOWIAK

Original Issue Date

09/16/2021

Effective Date

09/16/2021

Expiration Date

03/01/2022

City

WEST ALLIS

State

Zip

53219

Ever Disciplined

LastModifiedDate

07/27/2022