DAVID ALBERT COOK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

NOT RENEWED

Business

First Name

DAVID ALBERT

Last Name

COOK

Suffix

DMD

Business Name

DAVID ALBERT COOK DMD

Original Issue Date

08/24/1990

Effective Date

01/08/2009

Expiration Date

09/30/2009

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/04/2009