JOHN HUMPHREY JACOBSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063370

License Status

NOT RENEWED

Business

First Name

JOHN HUMPHREY

Last Name

JACOBSEN

Suffix

Business Name

JOHN HUMPHREY JACOBSEN MD

Original Issue Date

10/09/1981

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021