STACEY M MERRILL Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****31

License Status

INACTIVE

Business

First Name

STACEY

Middle

Last Name

MERRILL

Business Name

STACEY M MERRILL

Original Issue Date

04/30/2020

Effective Date

06/01/2022

Expiration Date

05/31/2024

City

PONTIAC

State

Zip

61764

County

LIVINGSTON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023