STACEY R HARMINSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

ACTIVE

Business

First Name

STACEY

Middle

Last Name

HARMINSON

Business Name

STACEY R HARMINSON

Original Issue Date

01/09/2002

Effective Date

12/08/2025

Expiration Date

03/01/2028

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/08/2025