MOLLY JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

MOLLY

Last Name

JACOB

Suffix

Business Name

MOLLY JACOB MD

Original Issue Date

06/28/1990

Effective Date

06/28/1990

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011