JACOB SAMSON FANG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084609

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

SAMSON

Last Name

FANG

Business Name

JACOB SAMSON FANG MD

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/06/2025