STACEY RENE LEWIS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

ACTIVE

Business

First Name

STACEY

Middle

RENE

Last Name

LEWIS

Business Name

STACEY RENE LEWIS

Original Issue Date

07/26/2016

Effective Date

02/01/2026

Expiration Date

03/01/2028

City

EVANSTON

State

Zip

60201

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/01/2026