WILLIE J RUCKER Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000299

License Status

ACTIVE

Business

First Name

WILLIE

Middle

Last Name

RUCKER

Business Name

WILLIE J RUCKER

Original Issue Date

10/08/1991

Effective Date

09/22/2024

Expiration Date

09/30/2027

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

09/22/2024