PREMA P JACOB Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****08

License Status

ACTIVE

Business

First Name

PREMA

Middle

Last Name

JACOB

Business Name

PREMA P JACOB

Original Issue Date

01/19/2006

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

NAPERVILLE

State

Zip

60564

County

WILL

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/03/2026