STACY LAMAR HICKS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****48

License Status

NOT RENEWED

Business

First Name

STACY

Middle

LAMAR

Last Name

HICKS

Business Name

STACY LAMAR HICKS

Original Issue Date

10/25/2019

Effective Date

02/04/2020

Expiration Date

03/01/2022

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022