GORDON LOUIS STASTNY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

NOT RENEWED

Business

First Name

GORDON LOUIS

Last Name

STASTNY

Business Name

GORDON LOUIS STASTNY

Original Issue Date

01/01/1998

Expiration Date

09/30/1984

City

COAL CITY

State

Zip

60416

County

GRUNDY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005