JEROME B AUSTRIACO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

ACTIVE

Business

First Name

JEROME B

Last Name

AUSTRIACO

Business Name

JEROME B AUSTRIACO

Original Issue Date

10/07/1988

Effective Date

05/10/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2024