JEFFREY DANIEL JACOBS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

Title

First Name

JEFFREY

Middle

DANIEL

Last Name

JACOBS

Business Name

JEFFREY DANIEL JACOBS MD

Original Issue Date

04/20/2016

Effective Date

04/20/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017