JUSTIN MICHAEL JACOBSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005085

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

MICHAEL

Last Name

JACOBSON

Business Name

JUSTIN MICHAEL JACOBSON

Original Issue Date

07/23/2014

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/03/2025