ERIC L ROUSH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000774

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

Last Name

ROUSH

Business Name

ERIC L ROUSH

Original Issue Date

06/24/1994

Effective Date

06/24/1994

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005