Person Information

Name:STACY A MILLER

Address Information

Address(city state zipcode):PETROLIA PA16050

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005973
Profession:NursingStatus:Agreement Terminated
Issue Date:1/12/2007Expires:10/31/2009Last Renewed:8/6/2007

Prerequisite Information

Licensee:MERCURIO, RICHARD ARelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD031126EStatus:Active
Date of Association:1/12/2007Date of Expiration:11/1/2007

Licensee:MILLER, STACY ARelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:VP006645BStatus:Active
Date of Association:Date of Expiration:

License CSR Information

Drug Schedule 2:YDrug Schedule 3:Drug Schedule 4:Drug Schedule 5:

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