SUMA JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111292

License Status

NOT RENEWED

Business

First Name

SUMA

Last Name

JACOB

Suffix

Business Name

SUMA JACOB MD

Original Issue Date

05/18/2004

Effective Date

06/08/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014