MICHAEL A JACOBS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

INACTIVE

Business

First Name

MICHAEL A

Last Name

JACOBS

Business Name

MICHAEL A JACOBS

Original Issue Date

08/10/1983

Effective Date

09/19/2018

Expiration Date

12/31/2021

City

CHICAGO

State

Zip

60638

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/21/2021