BENJAMIN JOHN JACOBS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117999

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

JOHN

Last Name

JACOBS

Suffix

Business Name

BENJAMIN JOHN JACOBS MD

Original Issue Date

04/03/2007

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

CAMAS

State

Zip

98607

County

WASHINGTON STATE

Ever Disciplined

LastModifiedDate

11/17/2014