STEVEN M JACOBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000717

License Status

NOT RENEWED

Business

First Name

STEVEN

Middle

Last Name

JACOBS

Business Name

STEVEN M JACOBS

Original Issue Date

02/06/1996

Effective Date

01/05/2022

Expiration Date

03/01/2024

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

02/05/2025