JACOB EDWARD JOHNSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****91

License Status

ACTIVE

Business

First Name

JACOB

Middle

EDWARD

Last Name

JOHNSON

Business Name

JACOB EDWARD JOHNSON

Original Issue Date

08/03/2025

Effective Date

08/03/2025

Expiration Date

05/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026