MATTHEW RALPH BAUMGARTH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

First Name

MATTHEW RALPH

Last Name

BAUMGARTH

Business Name

MATTHEW RALPH BAUMGARTH

Original Issue Date

06/18/1998

Effective Date

06/18/1998

Expiration Date

09/30/1998

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005