License holder summary

David Russell Jacobson is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for David Russell Jacobson is 66748 COUNTY ROAD 13, GOSHEN IN 46526. This licensed professional license is not current. The license was granted 11/18/1988 and expired on 06/30/1993.

Indiana

Professional Licensing Agency

David Russell Jacobson
Controlled Substance Registration - Physician
License number
01037161B
Date granted
11/18/1988
Date expires
06/30/1993
Class
Controlled Substance Registration - Physician
Status
Expired
Address
66748 COUNTY ROAD 13, GOSHEN IN 46526
indianalicensing.org
ID 5858502
LAST UPDATED 2024-03-19 16:00:36 UTC

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