RICHARD RANDALL JACOBS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

RICHARD

Middle

RANDALL

Last Name

JACOBS

Business Name

RICHARD RANDALL JACOBS MD

Original Issue Date

06/24/2010

Effective Date

07/20/2017

Expiration Date

09/30/2020

City

GLENVIEW

State

Zip

60026

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021