CATHLEEN M GASIOR Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

CANCELLED

Business

First Name

CATHLEEN M

Last Name

GASIOR

Business Name

CATHLEEN M GASIOR

Original Issue Date

01/07/2005

Effective Date

01/07/2005

Expiration Date

09/30/2006

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006