GRANT CHRISTIAN RUSSELL DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019034468

License Status

ACTIVE

Business

Title

DMD

First Name

GRANT

Middle

CHRISTIAN

Last Name

RUSSELL

Business Name

GRANT CHRISTIAN RUSSELL DMD

Original Issue Date

06/29/2023

Effective Date

08/27/2024

Expiration Date

09/30/2027

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

08/27/2024