JACOB PATRICK BRUNNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

Title

First Name

JACOB

Middle

PATRICK

Last Name

BRUNNER

Business Name

JACOB PATRICK BRUNNER MD

Original Issue Date

04/13/2020

Effective Date

04/13/2020

Expiration Date

07/31/2023

City

TINLEY PARK

State

Zip

60477

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023