RUSSELL GORDON BOOTHE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

RUSSELL GORDON

Last Name

BOOTHE

Business Name

RUSSELL GORDON BOOTHE

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005