CHARLES D GOODSITE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000461

License Status

NOT RENEWED

Business

First Name

CHARLES D

Last Name

GOODSITE

Suffix

DDS

Business Name

CHARLES D GOODSITE DDS

Original Issue Date

06/29/1990

Effective Date

06/29/1990

Expiration Date

06/30/1991

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005