THERESE H GUSTAFSON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019022154

License Status

INACTIVE

Business

First Name

THERESE H

Last Name

GUSTAFSON

Suffix

DDS

Business Name

THERESE H GUSTAFSON DDS

Original Issue Date

08/10/1990

Effective Date

09/14/2012

Expiration Date

09/30/2015

City

BARRINGTON

State

Zip

60010

County

LAKE

Ever Disciplined

LastModifiedDate

06/08/2015