GARTH R JACOBSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041064

License Status

EXPIRED

Business

First Name

GARTH

Middle

Last Name

JACOBSEN

Suffix

Business Name

GARTH R JACOBSEN MD

Original Issue Date

06/24/2000

Effective Date

06/24/2000

Expiration Date

06/23/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006