JACOB THOMAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

Title

First Name

JACOB

Last Name

THOMAS

Business Name

JACOB THOMAS MD

Original Issue Date

08/08/2011

Effective Date

08/24/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021