WALTER J JACOBSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

WALTER J

Last Name

JACOBSEN

Business Name

WALTER J JACOBSEN

Original Issue Date

11/02/1990

Effective Date

12/29/2014

Expiration Date

01/31/2017

City

CHICAGO

State

Zip

60659

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/27/2017