PRESTON ROBERT JACOB MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070476

License Status

CANCELLED

Business

Title

First Name

PRESTON

Middle

ROBERT

Last Name

JACOB

Business Name

PRESTON ROBERT JACOB MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/18/2017