BENJAMIN JOHN JACOBS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047229

License Status

EXPIRED

Business

First Name

BENJAMIN

Middle

JOHN

Last Name

JACOBS

Suffix

Business Name

BENJAMIN JOHN JACOBS MD

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2007

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

07/03/2007