SCOTT A JACOBSEN Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****05

License Status

ACTIVE

Business

First Name

SCOTT

Middle

Last Name

JACOBSEN

Business Name

SCOTT A JACOBSEN

Original Issue Date

02/11/2021

Effective Date

01/04/2025

Expiration Date

01/31/2027

City

LAKE BLUFF

State

Zip

60044

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025