EDGAR DEMAREST GIFFORD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****82

License Status

NOT RENEWED

Business

First Name

EDGAR DEMAREST

Last Name

GIFFORD

Business Name

EDGAR DEMAREST GIFFORD

Original Issue Date

01/01/1998

Expiration Date

09/30/1986

City

LAGRANGE

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005