CRYSTAL A LACY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****42

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

Last Name

LACY

Business Name

CRYSTAL A LACY

Original Issue Date

04/01/2022

Effective Date

04/01/2022

Expiration Date

06/30/2024

City

CRESTWOOD

State

Zip

60418

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025