FREDERICK GUSTAVE DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

ACTIVE

Business

First Name

FREDERICK

Last Name

GUSTAVE

Suffix

DDS

Business Name

FREDERICK GUSTAVE DDS

Original Issue Date

03/09/1995

Effective Date

09/15/2024

Expiration Date

09/30/2027

City

MARION

State

Zip

62959

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/15/2024