STEPHANIE K CLARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

ACTIVE

Business

First Name

STEPHANIE

Middle

Last Name

CLARK

Business Name

STEPHANIE K CLARK

BusinessDBA

STEPHANIE LUCAS

Original Issue Date

02/09/2022

Effective Date

04/29/2024

Expiration Date

05/31/2026

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026