STACY THERESE HEITZ Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

ACTIVE

Business

First Name

STACY

Middle

THERESE

Last Name

HEITZ

Business Name

STACY THERESE HEITZ

Original Issue Date

11/24/2021

Effective Date

02/27/2026

Expiration Date

03/01/2028

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/27/2026