SHINY MATHEW NANTHIKATTU Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****44

License Status

ACTIVE

Business

First Name

SHINY

Middle

MATHEW

Last Name

NANTHIKATTU

Business Name

SHINY MATHEW NANTHIKATTU

Original Issue Date

08/15/2019

Effective Date

03/26/2026

Expiration Date

05/31/2028

City

CREST HILL

State

Zip

60403

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/26/2026