LAWRENCE DAVID JACOBS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104673

License Status

INACTIVE

Business

First Name

LAWRENCE

Middle

DAVID

Last Name

JACOBS

Suffix

Business Name

LAWRENCE DAVID JACOBS MD

Original Issue Date

05/11/2001

Effective Date

05/11/2001

Expiration Date

07/31/2005

City

BUFFALO

State

Zip

14216

County

NEW YORK

Ever Disciplined

LastModifiedDate

10/09/2006