ANTONY T JACOB MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012959

License Status

EXPIRED

Business

First Name

ANTONY T

Last Name

JACOB

Suffix

Business Name

ANTONY T JACOB MD

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

07/01/1983

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006