RUSSELL EDWARD KLEIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019016726

License Status

NOT RENEWED

Business

First Name

RUSSELL EDWARD

Last Name

KLEIN

Suffix

DMD

Business Name

RUSSELL EDWARD KLEIN DMD

Original Issue Date

07/03/1979

Effective Date

06/17/2015

Expiration Date

09/30/2018

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/31/2018