STACEY ILLYSE BECKER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****22

License Status

ACTIVE

Business

First Name

STACEY

Middle

ILLYSE

Last Name

BECKER

Business Name

STACEY ILLYSE BECKER

Original Issue Date

12/10/2003

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

GLENVIEW

State

Zip

60026

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025