JACK CAPODICE JR Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000309

License Status

ACTIVE

Business

First Name

JACK

Last Name

CAPODICE JR

Business Name

JACK CAPODICE JR

Original Issue Date

02/22/1992

Effective Date

08/02/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

08/02/2024