MICHAEL R JACOBY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

JACOBY

Suffix

Business Name

MICHAEL R JACOBY MD

Original Issue Date

01/01/1997

Effective Date

10/31/2017

Expiration Date

09/30/2020

City

LAKE BARRINGTON

State

Zip

60010

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021