NEETHU JACOB - Physician Assistant License in Illinois | # 085006171

NEETHU JACOB

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006171

License Status

NOT RENEWED

Business

N

First Name

NEETHU

Last Name

JACOB

Business Name

NEETHU JACOB

Original Issue Date

04/06/2017

Effective Date

02/26/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020