JODI R BULT Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****30

License Status

NOT RENEWED

Business

First Name

JODI

Middle

Last Name

BULT

Business Name

JODI R BULT

Original Issue Date

08/30/2001

Effective Date

08/30/2001

Expiration Date

05/31/2006

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/09/2006