DANIEL PATRICK JACOBS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

CANCELLED

Business

First Name

DANIEL

Middle

PATRICK

Last Name

JACOBS

Suffix

Business Name

DANIEL PATRICK JACOBS MD

Original Issue Date

03/04/2002

Effective Date

03/04/2002

Expiration Date

07/31/2005

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006