RUSSELL GORDON BOOTHE - Dentist License in Illinois | # 021000111

RUSSELL GORDON BOOTHE

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000111

License Status

NOT RENEWED

Business

N

First Name

RUSSELL GORDON

Last Name

BOOTHE

Business Name

RUSSELL GORDON BOOTHE

Original Issue Date

12/03/1942

Effective Date

12/03/1942

Expiration Date

09/30/1984

State

IL

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

N

LastModifiedDate

10/13/2005