ANN JACOB MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069375

License Status

CANCELLED

Business

Title

First Name

ANN

Last Name

JACOB

Business Name

ANN JACOB MD

Original Issue Date

06/26/2016

Effective Date

06/26/2016

Expiration Date

06/25/2019

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

06/01/2016