ANDREW J BIFULK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****31

License Status

ACTIVE

Business

First Name

ANDREW

Middle

Last Name

BIFULK

Business Name

ANDREW J BIFULK

Original Issue Date

11/30/2021

Effective Date

05/29/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026