JACOB SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036076501

License Status

NOT RENEWED

Business

First Name

JACOB

Last Name

SAMUEL

Suffix

Business Name

JACOB SAMUEL MD

Original Issue Date

12/22/1987

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

MOKENA

State

Zip

60448

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021