LUCIA MARIE JIARDINA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

ACTIVE

Business

First Name

LUCIA

Middle

MARIE

Last Name

JIARDINA

Business Name

LUCIA MARIE JIARDINA

Original Issue Date

07/16/2021

Effective Date

09/11/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61704

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/11/2024