ELAINE GUSTAVSON - Dentist License in Illinois | # 020001311

ELAINE GUSTAVSON

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001311

License Status

INACTIVE

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

06/04/2009