RUSSELL ALAN WILLIAMS DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

RUSSELL ALAN

Last Name

WILLIAMS

Suffix

DMD

Business Name

RUSSELL ALAN WILLIAMS DMD

Original Issue Date

12/09/1986

Effective Date

08/08/2011

Expiration Date

09/30/2012

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012