ANSUMOL JACOB - Registered Nurse License in Pennsylvania | # 041463366

ANSUMOL JACOB

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041463366

License Status

NOT RENEWED

Business

N

First Name

ANSUMOL

Last Name

JACOB

Business Name

ANSUMOL JACOB

Original Issue Date

03/29/2018

Effective Date

03/29/2018

Expiration Date

09/30/2020

State

PA

Ever Disciplined

N

LastModifiedDate

01/14/2021