SUSAN JACOB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

Title

First Name

SUSAN

Last Name

JACOB

Business Name

SUSAN JACOB MD

Original Issue Date

01/12/2004

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2023