KALEB LYDON JACOBS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

First Name

KALEB

Middle

LYDON

Last Name

JACOBS

Suffix

Business Name

KALEB LYDON JACOBS DO

Original Issue Date

03/08/2017

Effective Date

04/26/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/26/2023