JEREMY THOMAS PETERSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012096

License Status

ACTIVE

Business

First Name

JEREMY

Middle

THOMAS

Last Name

PETERSON

Business Name

JEREMY THOMAS PETERSON

Original Issue Date

06/19/2007

Effective Date

08/14/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

08/14/2024