CARL BOUCHARD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001269

License Status

EXPIRED

Business

First Name

CARL

Last Name

BOUCHARD

Business Name

CARL BOUCHARD

Original Issue Date

06/13/2001

Effective Date

06/13/2001

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005