JACOB DAVID RUDOLPH MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049270552

License Status

NOT RENEWED

Business

Title

First Name

JACOB

Middle

DAVID

Last Name

RUDOLPH

Business Name

JACOB DAVID RUDOLPH MD

Original Issue Date

01/24/2020

Effective Date

01/24/2020

Expiration Date

03/31/2021

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/20/2021