STACEY E BROWN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****34

License Status

INACTIVE

Business

First Name

STACEY

Middle

Last Name

BROWN

Business Name

STACEY E BROWN

Original Issue Date

08/10/2017

Effective Date

06/10/2020

Expiration Date

05/31/2022

City

GIBSON CITY

State

Zip

60936

County

FORD

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2020