Lissiamma Jacob Md

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

036054052

Status

Inactive

First issued

January 13, 1977

Expired

July 31, 2014

License holder

Lissiamma Jacob Md

Entity type

Individual

Classifications

• Licensed Physician and Surgeon (Medical Board) Physicians & Surgeons

More from the license record

Current term began

07/15/2011

Other Illinois licenses under this name

• IL
  Lissiamma Jacob Md

  License 33*****36

  Licensed Physician Controlled Substance (Medical Board)
  Expired

  Peoria, IL

  Expired Jul 31, 2014

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