ELIZABETH MARIE JACOBSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000811

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

MARIE

Last Name

JACOBSEN

Business Name

ELIZABETH MARIE JACOBSEN

Original Issue Date

06/24/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

03/09/2017