JACOB MICHAEL MAZZA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075937

License Status

CANCELLED

Business

Title

First Name

JACOB

Middle

MICHAEL

Last Name

MAZZA

Business Name

JACOB MICHAEL MAZZA MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

05/20/2020