JASON JON CARLSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

ACTIVE

Business

First Name

JASON

Middle

JON

Last Name

CARLSON

Business Name

JASON JON CARLSON

Original Issue Date

07/16/2015

Effective Date

05/30/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2024