DONALD C GUNDLACH DDS 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

DONALD C

Last Name

GUNDLACH

Suffix

DDS

Business Name

DONALD C GUNDLACH DDS

Original Issue Date

04/14/1992

Effective Date

04/14/1992

Expiration Date

09/30/2004

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005