BRIAN PATRICK JACQUOT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

ACTIVE

Business

First Name

BRIAN

Middle

PATRICK

Last Name

JACQUOT

Business Name

BRIAN PATRICK JACQUOT

Original Issue Date

01/18/2002

Effective Date

12/16/2025

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61603

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/16/2025