GARY MARTIN RASKA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

First Name

GARY

Middle

MARTIN

Last Name

RASKA

Suffix

DMD

Business Name

GARY MARTIN RASKA DMD

Original Issue Date

07/20/2000

Effective Date

09/30/2009

Expiration Date

09/30/2012

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012