STACIE LYNN JOHNSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

ACTIVE

Business

First Name

STACIE

Middle

LYNN

Last Name

JOHNSON

Business Name

STACIE LYNN JOHNSON

Original Issue Date

03/03/2005

Effective Date

02/03/2026

Expiration Date

03/01/2028

City

MCHENRY

State

Zip

60050

County

MCHENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/03/2026