JACOB NATHANIEL MATTOX MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

NATHANIEL

Last Name

MATTOX

Business Name

JACOB NATHANIEL MATTOX MD

Original Issue Date

10/31/2022

Effective Date

04/23/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/23/2023