MARTIN LEE JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

MARTIN LEE

Last Name

JACOB

Suffix

Business Name

MARTIN LEE JACOB MD

Original Issue Date

07/12/1983

Effective Date

07/12/1983

Expiration Date

07/31/1990

City

JOLIET

State

Zip

60435

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006