EMILY CATHLEEN GUSTAFSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010693

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2012