JIBI JACOB Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****84

License Status

ACTIVE

Business

First Name

JIBI

Last Name

JACOB

Business Name

JIBI JACOB

Original Issue Date

04/09/2022

Effective Date

04/08/2024

Expiration Date

05/31/2026

City

STONE PARK

State

Zip

60165

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026