GARY TODD KLEIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

GARY

Middle

TODD

Last Name

KLEIN

Suffix

DDS

Business Name

GARY TODD KLEIN DDS

Original Issue Date

07/30/1985

Effective Date

07/30/1985

Expiration Date

09/30/1990

City

CHICAGO

State

Zip

60645

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005