JACOB HOLLAND SHIELDS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057934

License Status

CANCELLED

Business

Title

First Name

JACOB

Middle

HOLLAND

Last Name

SHIELDS

Business Name

JACOB HOLLAND SHIELDS MD

Original Issue Date

06/23/2013

Effective Date

06/23/2013

Expiration Date

06/22/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/02/2013