MERCEDITA C JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

MERCEDITA C

Last Name

JACOB

Suffix

Business Name

MERCEDITA C JACOB MD

Original Issue Date

08/17/1993

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021