JACOB LEO STALLBAUMER Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****94

License Status

ACTIVE

Business

First Name

JACOB

Middle

LEO

Last Name

STALLBAUMER

Business Name

JACOB LEO STALLBAUMER

Original Issue Date

05/27/2022

Effective Date

03/13/2024

Expiration Date

03/31/2026

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/08/2026