DEREK J STORCK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****76

License Status

ACTIVE

Business

First Name

DEREK

Middle

Last Name

STORCK

Business Name

DEREK J STORCK

Original Issue Date

12/29/2017

Effective Date

03/23/2026

Expiration Date

05/31/2028

City

SAINT PETER

State

Zip

62880

County

FAYETTE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/23/2026