JACOB SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

JACOB

Last Name

SAMUEL

Suffix

Business Name

JACOB SAMUEL MD

Original Issue Date

02/06/1991

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

MOKENA

State

Zip

60448

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021