ELIZABETH MARIE JACOBSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

MARIE

Last Name

JACOBSEN

Business Name

ELIZABETH MARIE JACOBSEN

Original Issue Date

10/24/2014

Effective Date

01/24/2019

Expiration Date

01/31/2021

City

ROCK ISLAND

State

Zip

61201

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021