MICHAEL P GIBBONS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

MICHAEL P

Last Name

GIBBONS

Suffix

DDS

Business Name

MICHAEL P GIBBONS DDS

Original Issue Date

05/04/1983

Effective Date

08/17/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018