DANIEL S JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

Last Name

JACOB

Business Name

DANIEL S JACOB MD

Original Issue Date

03/26/1998

Effective Date

02/13/2019

Expiration Date

09/30/2020

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021