DAVID LEE GASTON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

DAVID LEE

Last Name

GASTON

Business Name

DAVID LEE GASTON

Original Issue Date

09/29/1982

Effective Date

09/05/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022