JUSTIN SCOTT FULKERSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****66

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

SCOTT

Last Name

FULKERSON

Business Name

JUSTIN SCOTT FULKERSON

Original Issue Date

10/03/2011

Effective Date

05/10/2012

Expiration Date

05/31/2014

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

07/03/2014