RAPHAEL V GOLDSTEIN DDS 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

RAPHAEL V

Last Name

GOLDSTEIN

Suffix

DDS

Business Name

RAPHAEL V GOLDSTEIN DDS

Original Issue Date

06/11/1990

Effective Date

06/11/1990

Expiration Date

09/30/1994

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005