STACY JEANNE LAACK Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001482

License Status

INACTIVE

Business

First Name

STACY

Middle

JEANNE

Last Name

LAACK

Business Name

STACY JEANNE LAACK

Original Issue Date

11/13/2000

Effective Date

11/13/2000

Expiration Date

03/01/2006

City

CLERMONT

State

Zip

34711

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/09/2006