JENNIFER M JACOBS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930773

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

JACOBS

Suffix

Business Name

JENNIFER M JACOBS OD

Original Issue Date

12/09/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2008