ELAINE GUSTAVSON Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001311

License Status

INACTIVE

Business

First Name

ELAINE

Last Name

GUSTAVSON

Business Name

ELAINE GUSTAVSON

Original Issue Date

07/07/1970

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

LAKE BLUFF

State

Zip

60044

County

LAKE

Ever Disciplined

LastModifiedDate

06/04/2009