STACY T ERVIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****79

License Status

ACTIVE

Business

First Name

STACY

Middle

Last Name

ERVIN

Business Name

STACY T ERVIN

Original Issue Date

07/26/2016

Effective Date

04/12/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026