AMITH GEORGE JACOB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146096

License Status

ACTIVE

Business

Title

First Name

AMITH

Last Name

GEORGE JACOB

Business Name

AMITH GEORGE JACOB MD

Original Issue Date

05/11/2018

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/22/2023