WALTER J JACOBSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016004485

License Status

NOT RENEWED

Business

First Name

WALTER J

Last Name

JACOBSEN

Business Name

WALTER J JACOBSEN

Original Issue Date

09/29/1990

Effective Date

12/29/2014

Expiration Date

01/31/2017

City

CHICAGO

State

Zip

60659

County

COOK

Ever Disciplined

LastModifiedDate

03/27/2017