JACOB WILLIAM JARZEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

Title

DMD

First Name

JACOB

Middle

WILLIAM

Last Name

JARZEN

Business Name

JACOB WILLIAM JARZEN DMD

Original Issue Date

09/04/2018

Effective Date

09/04/2018

Expiration Date

01/31/2022

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022