JAMES RUSSELL FORDYCE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

JAMES RUSSELL

Last Name

FORDYCE

Business Name

JAMES RUSSELL FORDYCE

Original Issue Date

01/01/1998

Expiration Date

09/30/1994

City

ELMHURST

State

Zip

60126

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005