GARY K JACOBSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

First Name

GARY

Middle

Last Name

JACOBSON

Suffix

DDS

Business Name

GARY K JACOBSON DDS

Original Issue Date

03/28/2014

Effective Date

03/28/2014

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016