LACEY M MANIMALA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209030375

License Status

ACTIVE

Business

First Name

LACEY

Middle

Last Name

MANIMALA

Business Name

LACEY M MANIMALA

Original Issue Date

08/26/2024

Effective Date

08/26/2024

Expiration Date

05/31/2026

City

OAK PARK

State

Zip

60304

Ever Disciplined

LastModifiedDate

03/02/2026