JACOB ERIC DAVID MOORE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059970

License Status

EXPIRED

Business

Title

First Name

JACOB

Middle

ERIC DAVID

Last Name

MOORE

Business Name

JACOB ERIC DAVID MOORE MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/13/2015