CAROLYN A BAUTISTA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

ACTIVE

Business

First Name

CAROLYN A

Last Name

BAUTISTA

Business Name

CAROLYN A BAUTISTA

Original Issue Date

08/15/2019

Effective Date

03/13/2026

Expiration Date

05/31/2028

City

LAKE BLUFF

State

Zip

60044

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/13/2026