JACOB RALPH HENINGER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141802

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

RALPH

Last Name

HENINGER

Business Name

JACOB RALPH HENINGER DO

Original Issue Date

10/03/2016

Effective Date

04/16/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2023