DAVID R PETERSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000021

License Status

ACTIVE

Business

First Name

DAVID R

Last Name

PETERSON

Suffix

DDS

Business Name

DAVID R PETERSON DDS

Original Issue Date

01/01/1998

Effective Date

08/28/2024

Expiration Date

09/30/2027

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

DEEP SEDATION AND GENERAL ANESTHESIA

Ever Disciplined

LastModifiedDate

02/10/2026