RUSSELL THOMAS WILLIAMSON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

RUSSELL THOMAS

Last Name

WILLIAMSON

Suffix

DMD

Business Name

RUSSELL THOMAS WILLIAMSON DMD

Original Issue Date

01/01/1998

Expiration Date

01/01/1998

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005