JASON P THEOBALD DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****39

License Status

ACTIVE

Business

First Name

JASON

Middle

Last Name

THEOBALD

Suffix

DDS

Business Name

JASON P THEOBALD DDS

Original Issue Date

08/27/2007

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2024