JACOB PHILIP FYDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

PHILIP

Last Name

FYDA

Business Name

JACOB PHILIP FYDA MD

Original Issue Date

08/20/2018

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023