STACEY LEA WARD Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****14

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

LEA

Last Name

WARD

Business Name

STACEY LEA WARD

Original Issue Date

09/21/2017

Effective Date

05/07/2022

Expiration Date

06/30/2024

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025