DAVID LEE GASTON Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

CANCELLED

Business

First Name

DAVID LEE

Last Name

GASTON

Business Name

DAVID LEE GASTON

Original Issue Date

09/01/1982

Effective Date

09/01/1982

Expiration Date

09/30/1986

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005