STACY JO KEGEL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

ACTIVE

Business

First Name

STACY

Middle

Last Name

KEGEL

Business Name

STACY JO KEGEL

Original Issue Date

01/04/2022

Effective Date

01/03/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60618

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025