JACOB BENJAMIN MANUEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048578

License Status

CANCELLED

Business

Title

First Name

JACOB

Middle

BENJAMIN

Last Name

MANUEL

Business Name

JACOB BENJAMIN MANUEL MD

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

05/15/2007