STEVEN M JACOBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

NOT RENEWED

Business

First Name

STEVEN

Middle

Last Name

JACOBS

Business Name

STEVEN M JACOBS

Original Issue Date

03/03/2015

Effective Date

01/13/2022

Expiration Date

03/01/2024

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025