EMILY ELIZABETH JACOBS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****28

License Status

INOPERATIVE

Business

First Name

EMILY

Middle

ELIZABETH

Last Name

JACOBS

Business Name

EMILY ELIZABETH JACOBS

Original Issue Date

10/01/2020

Effective Date

10/01/2020

Expiration Date

03/01/2022

City

MENOMONEE FALLS

State

Zip

53051

Ever Disciplined

LastModifiedDate

01/03/2022