DALIA T JACOB Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

First Name

DALIA

Middle

Last Name

JACOB

Business Name

DALIA T JACOB

Original Issue Date

07/20/2001

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

NORTHBROOK

State

Zip

60062

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023