JENNIFER M JACOBS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****84

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

JACOBS

Suffix

Business Name

JENNIFER M JACOBS OD

Original Issue Date

08/04/2003

Effective Date

03/11/2004

Expiration Date

03/31/2006

City

PLAINFIELD

State

Zip

60544

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006