GARY EDWARD BORDEN DDS 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

GARY

Middle

EDWARD

Last Name

BORDEN

Suffix

DDS

Business Name

GARY EDWARD BORDEN DDS

Original Issue Date

09/09/1981

Effective Date

09/09/1981

Expiration Date

06/01/1982

City

CHICAGO

State

Zip

60630

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005