JACOB NATHANIEL MATTOX MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075832

License Status

CANCELLED

Business

Title

First Name

JACOB

Middle

NATHANIEL

Last Name

MATTOX

Business Name

JACOB NATHANIEL MATTOX MD

Original Issue Date

06/22/2020

Effective Date

06/22/2020

Expiration Date

06/21/2023

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/27/2020