PHYLLIS A JACOBS Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041083661

License Status

INACTIVE

Business

First Name

PHYLLIS A

Last Name

JACOBS

Business Name

PHYLLIS A JACOBS

Original Issue Date

04/02/1956

Effective Date

04/02/1956

Expiration Date

05/31/2004

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/09/2006