MICHAEL B JACOBSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

JACOBSON

Business Name

MICHAEL B JACOBSON

Original Issue Date

07/14/2003

Effective Date

07/14/2003

Expiration Date

07/31/2005

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006