CHAD E JACOBS - Medical Doctor License in Illinois | # 125036451

CHAD E JACOBS

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036451

License Status

EXPIRED

Business

N

First Name

CHAD

Middle

E

Last Name

JACOBS

Business Name

CHAD E JACOBS

Original Issue Date

06/05/1997

Effective Date

06/05/1997

Expiration Date

06/30/2000

State

IL

Specialty/Qualifier

General Surgery

Ever Disciplined

N

LastModifiedDate

09/22/2006