JACOB EUGENE SMITH Perfusionist License verification

Business Entity

ACTIVE

License Type

Perfusionist

Description

LICENSED PERFUSIONIST

License Number

214000372

License Status

ACTIVE

Business

First Name

JACOB

Middle

EUGENE

Last Name

SMITH

Business Name

JACOB EUGENE SMITH

Original Issue Date

12/23/2015

Effective Date

02/04/2026

Expiration Date

04/30/2028

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

02/04/2026