GREGORY BURGESS WALSH DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

Title

DMD

First Name

GREGORY

Middle

BURGESS

Last Name

WALSH

Business Name

GREGORY BURGESS WALSH DMD

Original Issue Date

08/29/2012

Effective Date

08/29/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60707

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

02/08/2016