GAIL E BODZIOCH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

First Name

GAIL E

Last Name

BODZIOCH

Business Name

GAIL E BODZIOCH

Original Issue Date

08/12/1982

Effective Date

08/12/1982

Expiration Date

09/30/1986

City

CAHOKIA

State

Zip

62206

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005