STACY CATHERINE HENRY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

NOT RENEWED

Business

First Name

STACY

Middle

CATHERINE

Last Name

HENRY

Business Name

STACY CATHERINE HENRY

Original Issue Date

12/19/2022

Effective Date

12/19/2022

Expiration Date

03/01/2024

City

DAVENPORT

State

Zip

52807

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025