AMITH GEORGE JACOB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

Title

First Name

AMITH

Last Name

GEORGE JACOB

Business Name

AMITH GEORGE JACOB MD

Original Issue Date

06/14/2018

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

IOWA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023