MICHAEL B JACOBSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042301

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

JACOBSON

Business Name

MICHAEL B JACOBSON

Original Issue Date

06/28/2001

Effective Date

06/28/2001

Expiration Date

06/27/2004

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006