DOUGLAS VAN GORIN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

VAN

Last Name

GORIN

Business Name

DOUGLAS VAN GORIN

Original Issue Date

01/01/1998

Effective Date

11/12/2015

Expiration Date

09/30/2018

City

GLENVIEW

State

Zip

60025

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018