REBECCA DANIELLE STACK Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

First Name

REBECCA

Middle

DANIELLE

Last Name

STACK

Business Name

REBECCA DANIELLE STACK

Original Issue Date

06/18/2020

Effective Date

12/28/2024

Expiration Date

01/31/2027

City

CARY

State

Zip

60013

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025