ROBERT DOUGLAS BENJAMIN JAQUISS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107800

License Status

NOT RENEWED

Business

First Name

ROBERT DOUGLAS

Middle

BENJAMIN

Last Name

JAQUISS

Suffix

Business Name

ROBERT DOUGLAS BENJAMIN JAQUISS MD

Original Issue Date

09/09/2002

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

MEQUON

State

Zip

53092

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/14/2025