DALE GARY JACOBSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062281

License Status

NOT RENEWED

Business

First Name

DALE GARY

Last Name

JACOBSON

Suffix

Business Name

DALE GARY JACOBSON MD

Original Issue Date

06/16/1981

Effective Date

06/16/1981

Expiration Date

07/31/1987

City

WALWORTH

State

Zip

53184

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006