DEENA MARY JACOB MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063738

License Status

EXPIRED

Business

Title

First Name

DEENA

Middle

MARY

Last Name

JACOB

Business Name

DEENA MARY JACOB MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/16/2016