EMILY CATHLEEN GUSTAFSON - Dentist License in Illinois | # 020010693

EMILY CATHLEEN GUSTAFSON

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010693

License Status

NOT RENEWED

Business

N

First Name

EMILY

Middle

CATHLEEN

Last Name

GUSTAFSON

Business Name

EMILY CATHLEEN GUSTAFSON

Original Issue Date

07/09/2003

Effective Date

06/22/2009

Expiration Date

09/30/2012

State

IL

Ever Disciplined

N

LastModifiedDate

11/14/2012