KYLE G JACOBSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

Title

First Name

KYLE

Middle

Last Name

JACOBSEN

Business Name

KYLE G JACOBSEN MD

Original Issue Date

04/17/2019

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

BELLEVILLE

State

Zip

62226

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023