POTHEN JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072928

License Status

NOT RENEWED

Business

First Name

POTHEN

Last Name

JACOB

Suffix

Business Name

POTHEN JACOB MD

Original Issue Date

06/19/1986

Effective Date

06/19/1986

Expiration Date

07/31/1993

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006