STACY A PILLER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****88

License Status

INACTIVE

Business

First Name

STACY A

Last Name

PILLER

Business Name

STACY A PILLER

Original Issue Date

10/25/2016

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

MENDOTA

State

Zip

61342

County

LA SALLE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/12/2018