BRIAN J JACOBS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042891

License Status

EXPIRED

Business

First Name

BRIAN

Middle

Last Name

JACOBS

Business Name

BRIAN J JACOBS

Original Issue Date

07/18/2005

Effective Date

07/18/2005

Expiration Date

07/17/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Glaucoma Fellowship

Ever Disciplined

LastModifiedDate

09/22/2006