MICHAEL DAVID DEGOULD - Dentist License in Illinois | # 137000269

MICHAEL DAVID DEGOULD

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000269

License Status

ACTIVE

Business

N

First Name

MICHAEL DAVID

Last Name

DEGOULD

Business Name

MICHAEL DAVID DEGOULD

Original Issue Date

09/21/1990

Effective Date

05/02/2024

Expiration Date

09/30/2027

State

IL

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

N

LastModifiedDate

05/02/2024