CHARLES RUSSELL SHOWALTER JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

NOT RENEWED

Business

First Name

CHARLES RUSSELL

Last Name

SHOWALTER JR

Suffix

DDS

Business Name

CHARLES RUSSELL SHOWALTER JR DDS

Original Issue Date

02/28/1986

Effective Date

03/18/2015

Expiration Date

09/30/2015

City

WHEATON

State

Zip

60187

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016