LUSHAN A GORDON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

LUSHAN A

Last Name

GORDON

Suffix

DMD

Business Name

LUSHAN A GORDON DMD

Original Issue Date

06/04/1996

Effective Date

06/04/1996

Expiration Date

09/30/1998

City

CHICAGO

State

Zip

60603

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005