ELLEN JACOBSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099003

License Status

ACTIVE

Business

First Name

ELLEN

Last Name

JACOBSEN

Suffix

Business Name

ELLEN JACOBSEN MD

Original Issue Date

09/04/1998

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/27/2023