ELLEN M JACOBSEN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007402

License Status

INACTIVE

Business

First Name

ELLEN

Middle

Last Name

JACOBSEN

Business Name

ELLEN M JACOBSEN

Original Issue Date

03/17/2005

Effective Date

12/30/2015

Expiration Date

12/31/2017

City

PENSACOLA

State

Zip

32534

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/06/2017