STACEY J TEBBE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****70

License Status

ACTIVE

Business

First Name

STACEY

Middle

Last Name

TEBBE

Business Name

STACEY J TEBBE

Original Issue Date

04/09/2020

Effective Date

05/10/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026