CAMILLE N STACKHOUSE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****02

License Status

ACTIVE

Business

First Name

CAMILLE

Middle

Last Name

STACKHOUSE

Business Name

CAMILLE N STACKHOUSE

Original Issue Date

03/08/2010

Effective Date

02/06/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60049

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/06/2026