BRENT ROBERT JACOBSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051980

License Status

CANCELLED

Business

Title

First Name

BRENT

Middle

ROBERT

Last Name

JACOBSON

Business Name

BRENT ROBERT JACOBSON DO

Original Issue Date

06/25/2006

Effective Date

06/25/2006

Expiration Date

06/24/2009

City

HOUSTON

State

Zip

77040

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006