STACEY R JOHNSON Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****11

License Status

INACTIVE

Business

First Name

STACEY R

Last Name

JOHNSON

Business Name

STACEY R JOHNSON

Original Issue Date

12/30/2014

Effective Date

05/01/2024

Expiration Date

05/31/2026

City

COAL CITY

State

Zip

60416

County

GRUNDY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/18/2024