JACOB ROBERT MOORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

ROBERT

Last Name

MOORE

Business Name

JACOB ROBERT MOORE MD

Original Issue Date

06/29/2018

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/29/2024