AMY LYNN STACEY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****07

License Status

ACTIVE

Business

First Name

AMY

Middle

LYNN

Last Name

STACEY

Business Name

AMY LYNN STACEY

Original Issue Date

02/20/2020

Effective Date

02/23/2026

Expiration Date

03/01/2028

City

MARION

State

Zip

62959

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/23/2026