JAKE SON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

Title

DMD

First Name

JAKE

Last Name

SON

Business Name

JAKE SON DMD

Original Issue Date

11/05/2021

Effective Date

11/05/2021

Expiration Date

09/30/2024

City

TROY

State

Zip

48085

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025