GLENN M BAUTISTA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****39

License Status

ACTIVE

Business

First Name

GLENN

Middle

Last Name

BAUTISTA

Business Name

GLENN M BAUTISTA

Original Issue Date

11/29/2023

Effective Date

04/01/2024

Expiration Date

05/31/2026

City

SCHAUMBURG

State

Zip

60173

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026