STACY VAN VLEET Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

ACTIVE

Business

First Name

STACY

Last Name

VAN VLEET

Business Name

STACY VAN VLEET

Original Issue Date

04/08/2002

Effective Date

05/15/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026