GAY G BAUTISTA Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****41

License Status

INACTIVE

Business

First Name

GAY

Middle

Last Name

BAUTISTA

Business Name

GAY G BAUTISTA

Original Issue Date

01/11/2018

Effective Date

04/12/2024

Expiration Date

05/31/2026

City

SCHAUMBURG

State

Zip

60173

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2025