KACY MARIE STANDIFORD Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****57

License Status

ACTIVE

Business

First Name

KACY

Middle

MARIE

Last Name

STANDIFORD

Business Name

KACY MARIE STANDIFORD

Original Issue Date

10/29/2019

Effective Date

01/28/2026

Expiration Date

03/01/2028

City

GIBSON CITY

State

Zip

60936

County

FORD

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/28/2026