MARTIN ORVILLE GUSTAFSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000659

License Status

NOT RENEWED

Business

First Name

MARTIN

Middle

ORVILLE

Last Name

GUSTAFSON

Suffix

DDS

Business Name

MARTIN ORVILLE GUSTAFSON DDS

Original Issue Date

12/07/1970

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

GENEVA

State

Zip

60134

County

KANE

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

11/04/2009