KIMBERLY M ROUSH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

KIMBERLY M

Last Name

ROUSH

Suffix

DDS

Business Name

KIMBERLY M ROUSH DDS

Original Issue Date

08/02/1994

Effective Date

08/02/1994

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60630

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005