JACOB ISRAEL SHAW MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067654

License Status

CANCELLED

Business

Title

First Name

JACOB

Middle

ISRAEL

Last Name

SHAW

Business Name

JACOB ISRAEL SHAW MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/15/2015