BRIAN PATRICK JACQUOT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001321

License Status

ACTIVE

Business

First Name

BRIAN

Middle

PATRICK

Last Name

JACQUOT

Business Name

BRIAN PATRICK JACQUOT

Original Issue Date

12/30/1999

Effective Date

12/16/2025

Expiration Date

03/01/2028

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

12/16/2025