RACHEL SAMANTHA GOLDBERG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

Title

DMD

First Name

RACHEL

Middle

SAMANTHA

Last Name

GOLDBERG

Business Name

RACHEL SAMANTHA GOLDBERG DMD

Original Issue Date

10/22/2014

Effective Date

10/22/2014

Expiration Date

09/30/2015

City

HAINESVILLE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/27/2016