STEPHANIE SCHWALM JACOBS Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

CANCELLED

Business

First Name

STEPHANIE

Middle

SCHWALM

Last Name

JACOBS

Business Name

STEPHANIE SCHWALM JACOBS

Original Issue Date

09/12/2001

Effective Date

09/12/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006