GARY RICHARD HERBERGER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

NOT RENEWED

Business

Title

DDS

First Name

GARY

Middle

RICHARD

Last Name

HERBERGER

Business Name

GARY RICHARD HERBERGER DDS

Original Issue Date

09/25/1990

Effective Date

08/03/2009

Expiration Date

09/30/2012

City

CANTON

State

Zip

61520

County

FULTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012