JACOB ROSS SIMONOVICH DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

ACTIVE

Business

Title

DDS

First Name

JACOB

Middle

ROSS

Last Name

SIMONOVICH

Business Name

JACOB ROSS SIMONOVICH DDS

Original Issue Date

05/19/2017

Effective Date

09/06/2024

Expiration Date

09/30/2027

City

MENOMONEE FALLS

State

Zip

53051

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/06/2024