STACEY ANNE SHAW Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****73

License Status

ACTIVE

Business

First Name

STACEY

Middle

ANNE

Last Name

SHAW

Business Name

STACEY ANNE SHAW

Original Issue Date

02/25/2020

Effective Date

03/17/2026

Expiration Date

05/31/2028

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2026