GERALD A JACOBY MD - Athletics Professional License in Illinois | # 002020154-0002

GERALD A JACOBY MD

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED PHYSICIAN

License Number

002020154-0002

License Status

NOT RENEWED

Business

N

First Name

GERALD A

Last Name

JACOBY

Suffix

MD

Business Name

GERALD A JACOBY MD

Original Issue Date

06/04/1975

Effective Date

06/04/1975

Expiration Date

06/04/1976

State

IL

Ever Disciplined

N

LastModifiedDate

09/18/2006