JACOB SAMUEL DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

ACTIVE

Business

Title

DMD

First Name

JACOB

Last Name

SAMUEL

Business Name

JACOB SAMUEL DMD

Original Issue Date

06/20/2019

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

SAINT CHARLES

State

Zip

60174

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024