ROLAND M GIBSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

ACTIVE

Business

Title

DDS

First Name

ROLAND

Middle

Last Name

GIBSON

Business Name

ROLAND M GIBSON DDS

Original Issue Date

09/19/2012

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024