KALEB LYDON JACOBS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063154

License Status

CANCELLED

Business

First Name

KALEB

Middle

LYDON

Last Name

JACOBS

Suffix

Business Name

KALEB LYDON JACOBS DO

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

04/05/2016