MICHAEL B JACOBSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109556

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

JACOBSON

Business Name

MICHAEL B JACOBSON

Original Issue Date

06/26/2003

Effective Date

06/26/2003

Expiration Date

07/31/2005

City

SKOKIE

State

Zip

60077

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006