KATHLEEN A GORMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

NOT RENEWED

Business

First Name

KATHLEEN A

Last Name

GORMAN

Business Name

KATHLEEN A GORMAN

Original Issue Date

10/01/1990

Effective Date

10/01/1990

Expiration Date

09/30/1994

City

OAKBROOK

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005