RANDY RUSSELLE BARES Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001437

License Status

NOT RENEWED

Business

First Name

RANDY RUSSELLE

Last Name

BARES

Business Name

RANDY RUSSELLE BARES

Original Issue Date

07/08/1971

Effective Date

07/08/1971

Expiration Date

09/30/1992

City

TILTON

State

Zip

61833

County

VERMILION

Ever Disciplined

LastModifiedDate

10/12/2005