MARK S JACOBS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

MARK S

Last Name

JACOBS

Suffix

DDS

Business Name

MARK S JACOBS DDS

Original Issue Date

01/19/2024

Effective Date

01/19/2024

Expiration Date

09/30/2024

City

MELROSE PARK

State

Zip

60160

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025