GARY ECKBERG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

GARY

Last Name

ECKBERG

Business Name

GARY ECKBERG

Original Issue Date

01/01/1998

Effective Date

08/27/2012

Expiration Date

09/30/2015

City

WYANET

State

Zip

61379

County

BUREAU

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

02/08/2016