CHRISTINE E JACOBSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054992

License Status

CANCELLED

Business

Title

First Name

CHRISTINE

Middle

Last Name

JACOBSEN

Business Name

CHRISTINE E JACOBSEN MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/20/2008