GARY TODD KLEIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

GARY

Middle

TODD

Last Name

KLEIN

Suffix

DDS

Business Name

GARY TODD KLEIN DDS

Original Issue Date

05/05/1989

Effective Date

05/05/1989

Expiration Date

09/30/1992

City

LAKE VILLA

State

Zip

60046

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005