STACEY RENE LEWIS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005915

License Status

ACTIVE

Business

First Name

STACEY

Middle

RENE

Last Name

LEWIS

Business Name

STACEY RENE LEWIS

Original Issue Date

07/26/2016

Effective Date

02/01/2026

Expiration Date

03/01/2028

City

HAWTHORN WOODS

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

02/01/2026