BISSY KUMPUCKAL Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****72

License Status

ACTIVE

Business

First Name

BISSY

Last Name

KUMPUCKAL

Business Name

BISSY KUMPUCKAL

Original Issue Date

09/29/2017

Effective Date

05/07/2024

Expiration Date

05/31/2026

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026