MERCEDITA C JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

MERCEDITA C

Last Name

JACOB

Suffix

Business Name

MERCEDITA C JACOB MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60609

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020