ALEXANDER CHARLES JACOBS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

Title

First Name

ALEXANDER

Middle

CHARLES

Last Name

JACOBS

Business Name

ALEXANDER CHARLES JACOBS MD

Original Issue Date

08/25/2015

Effective Date

08/25/2015

Expiration Date

07/31/2017

City

SHOREWOOD

State

Zip

53211

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017