JACOB A THAYER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069338

License Status

EXPIRED

Business

Title

First Name

JACOB

Middle

Last Name

THAYER

Business Name

JACOB A THAYER MD

Original Issue Date

06/25/2019

Effective Date

06/25/2019

Expiration Date

06/25/2022

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Plastic Surgery

Ever Disciplined

LastModifiedDate

10/11/2022