KRISTEN M JACOBS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

ACTIVE

Business

First Name

KRISTEN

Middle

Last Name

JACOBS

Suffix

Business Name

KRISTEN M JACOBS MD

Original Issue Date

02/20/2002

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/17/2023