License holder summary

SUSAN L JACOB is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for SUSAN L JACOB is AMERICAN HEALTH NETWORD, 55 BRENDON WAY SUITE 100, ZIONSVILLE IN 46077. This licensed professional license is current. The license was granted 12/07/1998 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

SUSAN L JACOB
Controlled Substance Registration - Physician
License number
01049258B
Date granted
12/07/1998
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
AMERICAN HEALTH NETWORD, 55 BRENDON WAY SUITE 100, ZIONSVILLE IN 46077
indianalicensing.org
ID 5937247
LAST UPDATED 2024-02-25 16:20:00 UTC

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