KENNETH L GOULD III Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

CANCELLED

Business

First Name

KENNETH

Middle

Last Name

GOULD

Suffix

III

Business Name

KENNETH L GOULD III

Original Issue Date

08/19/1982

Effective Date

08/19/1982

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006