JACOB DANIEL MILLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

Title

First Name

JACOB

Middle

DANIEL

Last Name

MILLER

Business Name

JACOB DANIEL MILLER MD

Original Issue Date

07/14/2015

Effective Date

07/14/2015

Expiration Date

07/31/2017

City

ELMHURST

State

Zip

60126

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017