JACOB MANSKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

JACOB

Last Name

MANSKE

Business Name

JACOB MANSKE MD

Original Issue Date

12/05/2019

Effective Date

12/05/2019

Expiration Date

09/30/2020

City

OAK PARK

State

Zip

60304

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021