NEETHU JACOB Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006171

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

11/24/2020