GREGG L ROSE

Business Entity
ACTIVE

Dentist

LICENSED DENTIST CONTROLLED SUBSTANCE

31*****77

ACTIVE

N

GREGG L

ROSE

GREGG L ROSE

08/08/1990

05/01/2024

09/30/2027

CHAMPAIGN

IL

61821

CHAMPAIGN

II III IV V

N

05/01/2024