SCOTT DAVID GOLDMAN DDS - Dentist License in Illinois | # 137000766

SCOTT DAVID GOLDMAN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000766

License Status

NOT RENEWED

Business

N

First Name

SCOTT

Middle

DAVID

Last Name

GOLDMAN

Suffix

DDS

Business Name

SCOTT DAVID GOLDMAN DDS

Original Issue Date

09/17/2009

Effective Date

09/17/2009

Expiration Date

09/30/2012

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

11/14/2012