GARY DEAN ANDERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

GARY DEAN

Last Name

ANDERSON

Suffix

DDS

Business Name

GARY DEAN ANDERSON DDS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

11/04/2009