LIDIYA M JACOB Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

ACTIVE

Business

First Name

LIDIYA

Middle

Last Name

JACOB

Business Name

LIDIYA M JACOB

Original Issue Date

04/30/2020

Effective Date

03/14/2026

Expiration Date

05/31/2028

City

ORLAND PARK

State

Zip

60467

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/14/2026