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Licensing details for: 11218

Name: JEROME PETERSON DDS

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Sole Owner

Address of Record

29321 Paseo Aragon
SAN JUAN CAPISTRANO CA 92675-3648
ORANGE county
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Practice Location

29321 PASEO ARAGON
SAN JUAN CAPISTRANO CA 92675
ORANGE county
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Issuance Date

October 14, 2013

Expiration Date

February 28, 2027

Current Date / Time

June 6, 2025
2:18:53 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: PETERSON, JEROME NORMAN

License/Registration Type: Dentist License

License Number: 23551 Primary Status: Current - Active

Address :
2500 ALTON PKWY #202
IRVINE CA 92606
ORANGE COUNTY

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