STACEY DIANE WAGGONER Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041264704

License Status

ACTIVE

Business

First Name

STACEY

Middle

DIANE

Last Name

WAGGONER

Business Name

STACEY DIANE WAGGONER

Original Issue Date

09/24/1991

Effective Date

03/22/2026

Expiration Date

05/31/2028

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/22/2026