LISA J JACOBSEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027066

License Status

EXPIRED

Business

First Name

LISA

Middle

Last Name

JACOBSEN

Business Name

LISA J JACOBSEN

Original Issue Date

06/05/1991

Effective Date

06/05/1991

Expiration Date

06/20/1994

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006