GARY ALAN KAUFFMAN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000604

License Status

CANCELLED

Business

First Name

GARY

Middle

ALAN

Last Name

KAUFFMAN

Suffix

DDS

Business Name

GARY ALAN KAUFFMAN DDS

Original Issue Date

10/20/2003

Effective Date

10/20/2003

Expiration Date

09/30/2006

City

PEKIN

State

Zip

61554

County

TAZEWELL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

07/24/2006