MARK B JACOB DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000560

License Status

ACTIVE

Business

Title

DDS

First Name

MARK

Middle

Last Name

JACOB

Business Name

MARK B JACOB DDS

Original Issue Date

06/21/2002

Effective Date

05/29/2024

Expiration Date

09/30/2027

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

05/29/2024