Dental Board of California
Licensing details for: 23551
Name: PETERSON, JEROME NORMAN
License Type: Dentist
Primary Status: Current - Active
Secondary Status: Radiation Safety Certification issued by the Board
Address of Record
2500 ALTON PKWY #202
IRVINE CA 92606
ORANGE county
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: JEROME PETERSON DDS
License/Registration Type: Additional Office Permit
License Number: 11218 Primary Status: Current - Active
Address :
29321 PASEO ARAGON
SAN JUAN CAPISTRANO CA 92675
ORANGE COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: JEROME N. PETERSON, DDS
License/Registration Type: Additional Office Permit
License Number: 7292 Primary Status: Cancelled
Address :
33 BLAKELEY
IRVINE CA 92620
ORANGE COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: PETERSON, JEROME NORMAN
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3478 Primary Status: Cancelled
Address :
2500 ALTON PKWY #202
IRVINE CA 92606
ORANGE COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: PETERSON, JEROME NORMAN
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3420 Primary Status: Cancelled
Address :
3620 S. BRISTOL STREET 302
SANTA ANA CA 92704
ORANGE COUNTY
