SUMA JACOB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

SUMA

Last Name

JACOB

Suffix

Business Name

SUMA JACOB MD

Original Issue Date

05/19/2004

Effective Date

06/08/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60608

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014