JACOB A LANDVATTER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000845

License Status

EXPIRED

Business

Title

First Name

JACOB

Middle

Last Name

LANDVATTER

Business Name

JACOB A LANDVATTER MD

Original Issue Date

12/15/2019

Effective Date

12/15/2019

Expiration Date

06/14/2020

City

ROCKFORD

State

Zip

61103

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

11/19/2020