MARK JACOBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006218

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

JACOBS

Business Name

MARK JACOBS

Original Issue Date

06/28/2017

Effective Date

06/28/2017

Expiration Date

03/01/2018

City

EAU CLAIRE

State

Zip

54701

Ever Disciplined

LastModifiedDate

08/02/2024