THOMAS L GOUGH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

First Name

THOMAS L

Last Name

GOUGH

Business Name

THOMAS L GOUGH

Original Issue Date

06/29/1989

Effective Date

08/15/2018

Expiration Date

01/31/2022

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022