| | Physician Last Name: | Smith |
| | Physician First Name: | Jacob |
| | Physician Middle Name: | William |
| | Address: | Address redacted |
| | License Number: | 259377 |
| | License Type: | MD |
| | Year of Birth: |
1973
|
| | Effective Date: | 09/22/2021 |
| | Action Description for DOH Webpage: | License revocation. The Administrative Review Board affirmed the Hearing Committee’s penalty to revoke the physician’s New York State medical license. |
| | Misconduct Description for DOH Webpage: | The Administrative Review Board affirmed the Hearing Committee’s April 22, 2020 determination finding the physician guilty of committing professional misconduct by practicing the profession of medicine with negligence on more than one occasion; practicing the profession of medicine fraudulently; being dependent on or a habitual user of narcotics and failing to maintain accurate patient records. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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