NEETHU JACOB Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

INOPERATIVE

Business

First Name

NEETHU

Last Name

JACOB

Business Name

NEETHU JACOB

Original Issue Date

07/17/2017

Effective Date

02/26/2018

Expiration Date

03/01/2020

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

12/18/2019