JEFFREY DANIEL JACOBS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063215

License Status

CANCELLED

Business

Title

First Name

JEFFREY

Middle

DANIEL

Last Name

JACOBS

Business Name

JEFFREY DANIEL JACOBS MD

Original Issue Date

06/24/2013

Effective Date

06/24/2013

Expiration Date

06/23/2016

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014