DAVID G GUILBEAULT DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

ACTIVE

Business

First Name

DAVID

Middle

Last Name

GUILBEAULT

Suffix

DMD

Business Name

DAVID G GUILBEAULT DMD

Original Issue Date

06/19/2000

Effective Date

06/24/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/24/2024