JUSTIN MICHAEL JACOBSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****32

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

02/02/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/02/2026