ROBERT COLIN POULSOM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

Title

DDS

First Name

ROBERT

Middle

COLIN

Last Name

POULSOM

Business Name

ROBERT COLIN POULSOM DDS

Original Issue Date

01/01/1998

Effective Date

11/03/2021

Expiration Date

09/30/2024

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025