TONIA JACOB Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

ACTIVE

Business

First Name

TONIA

Last Name

JACOB

Business Name

TONIA JACOB

Original Issue Date

11/13/2024

Effective Date

11/13/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026