GARY MICHAEL JACOBSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

CANCELLED

Business

First Name

GARY MICHAEL

Last Name

JACOBSON

Suffix

Business Name

GARY MICHAEL JACOBSON MD

Original Issue Date

09/15/1995

Effective Date

09/15/1995

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60613

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006