LESLIE E RUSS JR Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****07

License Status

ACTIVE

Business

First Name

LESLIE E

Last Name

RUSS JR

Business Name

LESLIE E RUSS JR

Original Issue Date

10/22/1986

Effective Date

08/09/2024

Expiration Date

09/30/2027

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/09/2024